HEPATOCELLULAR INTEGRITY DURING AND AFTER ISOFLURANE AND HALOTHANE ANESTHESIA IN SURGICAL PATIENTS

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.