Comparison of effects of anaesthesia with desflurane and enflurane on liver function

INTRODUCTION

Although most general anaesthesia procedures are performed without any complications, volatile agents may have adverse effects on various living systems. This study aimed to compare the effects of desflurane and enflurane on liver function.

METHODS

40 patients, who were in the ASA I-III risk groups and were planned to undergo head and neck surgery of at least three hours' duration, were randomly divided into two groups: the desflurane (Group D) and enflurane groups (Group E). Venous blood samples (5 ml) of the patients were obtained before anaesthesia induction, in the postoperative first hour and on the first and seventh days. The samples were centrifuged and then stored at -80 degrees Celsius until the determination of glutathione S-transferase (GST) levels. For maintenance of anaesthesia in Group D, desflurane (6 percent) was used, while in Group E, enflurane (1.2 percent) was used.

RESULTS

GST levels were significantly higher in Group E in the postoperative first hour (p-value is 0.002), and on the first day (p-value is 0.025) and seventh day (p-value is 0.035), although there were no differences preoperatively (p-value is more than 0.05). When postoperative levels were compared with preoperative levels, the postoperative GST levels of Group E were significantly higher (first hour [p-value is 0.008], first day [p-value is 0.010], seventh day [p-value is 0.038]).

CONCLUSION

Subclinical hepatic injury after anaesthesia continues to be an issue of interest, particularly with the development of new, more sensitive methods of measuring GST levels. The increase in GST concentration after anaesthesia is thought to be a result of reduced hepatic blood flow. This study has shown that desflurane has fewer effects than enflurane on liver function tests in lengthy operations of up to 330 minutes.

Use of BIS monitor during anaesthesia of a narcoleptic patient for avoiding possible delayed emergence

Anaesthesia for a narcoleptic patient is not a common practice of anaesthesioligists' daily working life. Therefore special problems related to narcolepsy should be considered pre-, peroperatively and during emergence. The aim of presenting this case report is to emphasize the importance of BIS monitor use in a narcoleptic patient undergoing surgery under general anaesthesia to avoid possible prolonged emergence.