P. Tiainen et Ph. Rosenberg, HEPATOCELLULAR INTEGRITY DURING AND AFTER ISOFLURANE AND HALOTHANE ANESTHESIA IN SURGICAL PATIENTS, British Journal of Anaesthesia, 77(6), 1996, pp. 744-747
Subclinical disturbance in hepatocellular integrity, indicated by glut
athione transferase Alpha (GSTA), has been associated with halothane,
sevoflurane and propofol, but not with isoflurane anaesthesia. We anae
sthetized 82 patients with isoflurane or halothane at 1 MAC for superf
icial surgery. GSTA concentration were measured with a sensitive time-
resolved immunofluorometric assay in serum samples. GSTA concentration
s increased from a baseline value of geometric mean 1.8 mu g litre(-1)
(95% confidence intervals 1.4-2.2 mu g litre(-1)) to a peak of 4.3 (3
.3-5.7) mu g litre(-1) in the isoflurane group and from 2.1 (1.6-2.9)
mu g litre(-1) to 6.2 (4.1-9.5) mu g litre(-1) in the halothane group.
The change in GSTA was significant within groups but the difference b
etween groups was not significant. Two patients exhibited an unexpecte
dly large increase in GSTA (peaks 370 and 620 mu g litre(-1)) and a mi
ld increase in alanine aminotransferase after halothane anaesthesia. W
e conclude that hepatocellular integrity was mildly disturbed after is
oflurane and halothane anaesthesia but there was no difference between
anaesthetics. Halothane anaesthesia may be associated with more advan
ced hepatocellular disturbance in some cases.