EFFECT OF LONG DURATION SEVOFLURANE ANESTHESIA ON LIVER FUNCTION

Abstract

Background: Sevoflurane is an inhalational anesthetic agent for use in induction and maintenance of general anesthesia. Administration has been associated with a smooth, rapid loss of consciousness during inhalation induction and a rapid recovery following discontinuation of anesthesia. Minimum alveolar concentration (MAC) of sevoflurane in oxygen for a 40 year old adult is 2.1%. Sevoflurane can be administered to patients with normal or mild-to-moderately impaired hepatic functions. However, patients with severe hepatic dysfunction were not investigated. Objective: The present study was conducted to evaluate liver function of the patients who underwent sevoflurane anesthesia for long durations. Material and methods: In this prospective study, 20 patients undergoing surgery with sevoflurane as anesthetic were selected. Serum aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, alkaline phosphatase, and total bilirubin was measured by authenticated methods by using automated system (VITROS 2005, USA) preoperatively and 1st and 3rd day postoperatively. Results: Aspartate aminotransferase level significantly elevated on 1st postoperative day (p<0.001) and on 3rd postoperative day (p=0.012) as compared to preoperative value.Alanine aminotransferase level increased significantly on the1stpostoperative day (p<0.001) and on 3rd day postoperative day (p=0.003). Alkaline phosphatase decreased significantly in 1st postoperative day (p<0.001) and on 3rd postoperative day (p=0.309). Lactate dehydrogenase was decreased significantly in 1st postoperative day (p=0.004) and on 3rd postoperative day (p=0.017). Serum total bilirubin level was increased significantly on the 1st postoperative day (p<0.001) and on 3rd postoperative day (p=0.028). Conclusion: According to this study the liver enzymes and bilirubin were raised but not above reference range. Aspartate and Alanine amino transferase shown decline on 3rd day when compared to 1 st postoperative day. Hence long duration anesthesia by sevoflurane is relatively safe and not hepatotoxic.