Liver function after sevoflurane or isoflurane anaesthesia in neurosurgical patients.
OBJECTIVE
Although both sevoflurane and isoflurane are thought to be less hepatotoxic than halothane or enflurane, recent case reports have described liver injury after sevoflurane or isoflurane anaesthesia. There are no studies comparing liver function after sevoflurane or isoflurane anaesthesia. The purpose of this study was to compare serum liver enzyme concentrations in patients receiving either sevoflurane or isoflurane anaesthesia prospectively.


METHODS
Ninety patients scheduled for elective neurosurgery were studied. Serum concentrations of aspartame aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TBil), alkaline phosphatase (ALP), gamma-glutamyl transpeptidase (GTP), and lactate dehydrogenase (LDH) were measured before and, 1, 2, 3, 7, and 14 days after either sevoflurane (45 patients) or isoflurane (45 patients) anaesthesia.


RESULTS
AST, ALT and GTP increased peaking seven days after anaesthesia, especially in the isoflurane group. The numbers of patients with abnormal values in AST and ALT were not different in the isoflurane from that in the sevoflurane group. The increase in TBil peaked one day after anaesthesia in both groups.


CONCLUSIONS
Even in a small number of patients, isoflurane induced an elevation of serum levels of liver enzymes more frequently than did sevoflurane three to 14 days after anaesthesia.
Nishiyama
T
T
Department of Anesthesiology, University of Tokyo, Japan.
Yokoyama
T
T
Hanaoka
K
K
D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D018685:Anesthetics, Inhalation / Q000009:adverse effects*; D001219:Aspartate Aminotransferases / Q000097:blood; D006801:Humans; D007530:Isoflurane / Q000009:adverse effects*; D008099:Liver / Q000187:drug effects* / Q000503:physiopathology; D008738:Methyl Ethers / Q000009:adverse effects*; D008875:Middle Aged; D009493:Neurosurgery; D000077149:Sevoflurane; D005723:gamma-Glutamyltransferase / Q000097:blood
D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D007530:Isoflurane; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase