The Effect of General Anesthesia on Aminotransferase Levels in Patients with Elevated Aminotransferase Levels: A Single-Center 5-Year Retrospective Study.
BACKGROUND
The effect of commonly used anesthetics on postoperative aminotransferase levels in patients with preoperatively elevated values is unclear.


METHODS
The medical records of 25,567 adult patients undergoing elective general anesthesia were retrospectively reviewed. Patients were classified into normal (≤ 40 IU/L), mild (41-119 IU/L), moderate (120-199 IU/L), and marked elevation (200+ IU/L) groups according to their preoperative alanine aminotransferase levels. Changes in these levels before and after general anesthesia were compared according to the anesthetics used.


RESULTS
Among the patients with preoperative mild or moderate elevation, 97.8% (2589/2647) did not show a higher alanine aminotransferase level after surgery. Compared with total IV anesthesia (TIVA), sevoflurane showed adjusted odds ratios (95% confidence interval) of 1.27 (1.10-1.46) for mild, 1.33 (0.86-2.05) for moderate, and 3.35 (1.58-7.04) for marked postoperatively elevated levels of alanine aminotransferase versus normal levels. Similarly, compared with TIVA, desflurane showed adjusted odds ratios (95% confidence interval) of 1.21 (0.96-1.53) for mild, 1.44 (0.70-2.94) for moderate, and 3.18 (1.14-8.89) for marked postoperatively elevated levels of alanine aminotransferase versus normal levels (P = 0.05).


CONCLUSIONS
In most cases, postoperative alanine aminotransferase levels did not worsen even in patients with preoperatively elevated levels. Sevoflurane was associated with increased odds for postoperative elevation of these levels after general surgery compared with TIVA.
From the Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, South Korea.
Youn Joung
YJ
Cho
Young Jae
YJ
Park
Se Hee
SH
Min
Ho-Geol
HG
Ryu
D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood*; D000768:Anesthesia, General / Q000009:adverse effects; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies; D013997:Time Factors
D015415:Biomarkers; D000410:Alanine Transaminase