Hepatocellular integrity during and after isoflurane and halothane anaesthesia in surgical patients |
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Authors: | Tiainen P; Rosenberg P H |
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Institution: | Department of Anaesthesiology, Surgical Hospital, Helsinki University Central Hospital and Division of Biochemistry, Department of Biosciences, University of Helsinki, Helsinki, Finland; Department of Anaesthesiology, University of Helsinki, Helsinki, Finland |
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Abstract: | Subclinical disturbance in hepatocellular integrity, indicated by
glutathione transferase Alpha (GSTA), has been associated with halothane,
sevoflurane and propofol, but not with isoflurane anaesthesia. We
anaesthetized 82 patients with isoflurane or halothane at 1 MAC for
superficial surgery. GSTA concentration were measured with a sensitive
time-resolved immunofluorometric assay in serum samples. GSTA
concentrations increased from a baseline value of geometric mean 1.8
micrograms litre-1 (95% confidence intervals 1.4-2.2 micrograms litre-1) to
a peak of 4.3 (3.3-5.7) micrograms litre-1 in the isoflurane group and from
2.1 (1.6-2.9) micrograms litre-1 to 6.2 (4.1- 9.5) micrograms litre-1 in
the halothane group. The change in GSTA was significant within groups but
the difference between groups was not significant. Two patients exhibited
an unexpectedly large increase in GSTA (peaks 370 and 620 micrograms
litre-1) and a mild increase in alanine aminotransferase after halothane
anaesthesia. We conclude that hepatocellular integrity was mildly disturbed
after isoflurane and halothane anaesthesia but there was no difference
between anaesthetics. Halothane anaesthesia may be associated with more
advanced hepatocellular disturbance in some cases.
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