The effect of desflurane on liver function markers in infants and children. Report of a study and a pertinent case report.
BACKGROUND
In an open-labelled clinical trial, the effect of desflurane anaesthesia on liver function markers in paediatric patients was monitored.


METHODS
Fifty infants and children, 37 male, scheduled for elective cleft plate surgery were included in the study. Median age was 0.57 (0.25-5.45) years (range), mean desflurane exposure was 2.29 +/- 0.75 MAC-h. Function markers were determined within 24 h prior to and within 24-48 h after anaesthesia. Complete data sets were available for total bilirubin 29, aspartate aminotransferase (ASAT) 36, alanine aminotransferase (ALAT) 35, and for alkaline phosphatase (AP) 28. Pre- and postanaesthetic function tests were compared by means of Wilcoxon's matched-pairs test.


RESULTS
Only for AP could a statistically significant reduction of the postanaesthetic values be observed, while the other parameters showed no significant changes. Postanaesthetic ASAT and ALAT were clearly reduced in three children who had unspecific highly elevated preanaesthetic values. After the study, this observation could be repeated in at least one child, who received a further anaesthesia with desflurane within 3 months.


CONCLUSIONS
The data suggest that desflurane does not affect excretory or structural liver integrity in infants and children.
Wissing
H
H
Department of Anaesthesiology, Johann Wolfgang Goethe University Hospital, Frankfurt am Main, Germany. wissing@em.uni-frankfurt.de
Kuhn
I
I
D000410:Alanine Transaminase / Q000097:blood; D000469:Alkaline Phosphatase / Q000097:blood; D018685:Anesthetics, Inhalation / Q000009:adverse effects*; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood; D000077335:Desflurane; D005260:Female; D006207:Half-Life; D006801:Humans; D007223:Infant; D007530:Isoflurane / Q000009:adverse effects / Q000031:analogs & derivatives*; D008111:Liver Function Tests; D008297:Male
D018685:Anesthetics, Inhalation; D003404:Creatinine; D000077335:Desflurane; D007530:Isoflurane; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase; D001663:Bilirubin