[Mobilization of alpha-glutathione S-transferase in the anesthetized patient].
OBJECTIVE
To measure and assess changes in plasma concentrations of alpha glutathione S-transferase (alpha-GST) during and after anesthesia with isoflurane, desflurane and propofol.


METHODS
Study of 90 ASA I and II patients scheduled for lumbar back surgery under general anesthesia assigned randomly to one of three groups to receive anesthetic maintenance with isoflurane, desflurane or propofol. We measured plasma levels of alpha-GST, aspartate aminotransferase aspartate, alanine aminotransferase, alkaline phosphatase, pseudocholinesterase, gamma glutamyltransferase and total bilirubin at baseline and several times during and after surgery.


RESULTS
Changes in plasma levels of alpha-GST were detected in all three groups, the tendency to increase reaching its peak with the sample taken at the end of anesthesia. The ranges considered normal were not exceeded in any of the patients studied.


CONCLUSIONS
By measuring alpha-GST changes in plasma, we have detected signs of disturbance in hepatocellular integrity after anesthesia with all three maintenance agents used. However, the slight and transitory nature of the events confirms the scarce hepatotoxic potential of isoflurane, desflurane and propofol.
Granados Llamas
L M
LM
Departamento de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital de Rehabilitación y Traumatología, Ciudad Sanitaria Virgen del Rocío de Sevilla.
Navas Rivera
E
E
Marenco de la Fuente
M L
ML
Balanza Ortiz
R
R
Suárez Collazos
F
F
Puente Egido
J J
JJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000768:Anesthesia, General / Q000009:adverse effects; D000777:Anesthetics / Q000633:toxicity*; D018685:Anesthetics, Inhalation / Q000633:toxicity; D018686:Anesthetics, Intravenous / Q000633:toxicity; D056486:Chemical and Drug Induced Liver Injury / Q000201:enzymology / Q000209:etiology; D000077335:Desflurane; D004789:Enzyme Activation / Q000187:drug effects*; D005260:Female; D005982:Glutathione Transferase / Q000097:blood / Q000378:metabolism*; D006801:Humans; D007530:Isoflurane / Q000031:analogs & derivatives / Q000633:toxicity; D008099:Liver / Q000187:drug effects / Q000201:enzymology; D008297:Male; D008875:Middle Aged; D015742:Propofol / Q000633:toxicity
D000777:Anesthetics; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D000077335:Desflurane; D007530:Isoflurane; D005982:Glutathione Transferase; D015742:Propofol