EFFECT OF SEVOFLURANE ANESTHESIA ON PLASMA-CONCENTRATIONS OF GLUTATHIONE-S-TRANSFERASE

To assess the effect of sevoflurane anaesthesia on hepatocellular inte grity, we measured plasma concentrations of glutathione S-transferase (GST) before anaesthesia and 1, 3, 6 and 24 h after the end of anaesth esia in 41 healthy, Japanese patients undergoing elective, body surfac e surgery. Sevoflurane (approximately 1.0 MAC) was delivered in 50-66% nitrous oxide in oxygen via a circle system, with a fresh gas flow of 6 litre min(-1). Ventilation was spontaneous in all patients. Mean du ration of anaesthesia was 101 min. Concentrations of GST increased sig nificantly 1 h after the end of anaesthesia (P=0.0075), but this was n ot significantly different from preoperative concentrations at 3, 6 an d 24 h. Three patients developed a large secondary increase in GST con centrations at 24 h. The increase observed at 1 h was probably a resul t of reduced total liver blood flow; the mechanism for the secondary i ncrease at 24 h is unclear but the possibility that products of sevofl urane biotransformation are responsible cannot be excluded.