Hepatocellular integrity during sevoflurane anesthesia with induced hypotension.
The effect of sevoflurane anesthesia with or without induced hypotension on hepatocellular integrity was studied. Forty adult consented patients scheduled for various urological procedures were allocated randomly to either NTG group (nitroglycerin-induced hypotension) or a control group of twenty patients each. Anesthesia was induced and maintained by fentanyl, sevoflurane & vecuronium in both groups. In NTG group, nitro-glycerin infusion was adjusted to maintain mean arterial pressure (MAP) of 50-65 mm Hg. Specific and sensitive hepatic biomarkers; alpha (alpha) and pi (pi) glutathione S-transferases (GST) and hyaluronic acid (HA), also traditional liver enzymes; aspartate (AST) and alanine (ALT) aminotransferases were measured at: TO (pre-induction), T1, T2, T3 (15, 30 & 60 minutes after MAP stabilization respectively) and T4 (24 hours after anesthesia end). Plasma alpha-GST significantly increased at T3 in control group (p < 0.05) and in NTG group (p < 0.01) compared to TO in same group. In NTG group, hyaluronic acid con-centrations was significantly increased at T1, T2 (p < 0.05) and T3 (p < 0.01) from T0. Compared to control group, alpha- GST & HA concentrations showed significant increases in NTG group at T3 with p < 0.05 then returned back to normal range at T4. But, pi-GST, AST and ALT showed no significant changes throughout the study in both groups.
Department of Anesthesiology, Theodor Bilharz Research Institute, Imbaba P.O.B. 30, Giza, Egypt.
Maha A
MA
Yousif
Hanan F
HF
Khafagy
Faten M
FM
El-Shanawani
Hossam H
HH
El-Sabae
Sohaila H
SH
Omar
Mohamed N
MN
Allam
Hend H
HH
Kamel
D000328:Adult; D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D015415:Biomarkers; D005260:Female; D005982:Glutathione Transferase / Q000378:metabolism*; D006801:Humans; D006820:Hyaluronic Acid / Q000378:metabolism*; D007022:Hypotension / Q000139:chemically induced / Q000503:physiopathology*; D008099:Liver / Q000098:blood supply / Q000201:enzymology*; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage*; D008875:Middle Aged; D005996:Nitroglycerin; D000077149:Sevoflurane; D055815:Young Adult
D018685:Anesthetics, Inhalation; D015415:Biomarkers; D008738:Methyl Ethers; D000077149:Sevoflurane; D006820:Hyaluronic Acid; D005982:Glutathione Transferase; D005996:Nitroglycerin