CHANGES IN HEPATOCELLULAR INTEGRITY DURING AND AFTER DESFLURANE OR ISOFLURANE ANESTHESIA IN PATIENTS UNDERGOING BREAST SURGERY

We have assessed hepatocellular integrity in patients anaesthetized wi th desflurane or isoflurane using glutathione transferase Alpha (GSTA) as a sensitive indicator. Volatile anaesthetic was administered to 72 women at 0.7 MAC for 25 min and thereafter at 1.0 MAC. GSTA was measu red with a time-resolved immunofluorometric assay in serum samples. Mi ld or moderate increases in GSTA were found in approximately 40% of pa tients immediately after anaesthesia. In the desflurane group (n = 30) the increase in GSTA concentration was from a baseline value of the g eometric mean of 1.3 mu g litre(-1) (95% confidence interval 0.9-1.9 m u g litre(-1)) to a peak of 2.6 (1.8-3.8) mu g litre(-1). The correspo nding increase in the isoflurane group (n = 31) was from 1.3 (0.9-1.9) mu g litre(-1) to 3.0 (2.2-4.2) mu g litre(-1). The change in GSTA co ncentration was significant in both groups but not between groups. No predictive factors for the increase in GSTA concentrations were found. Increased GSTA concentrations were not accompanied by increases in am inotransferases. We conclude that desflurane and isoflurane anaesthesi a were associated with a mild subclinical disturbance of hepatocellula r integrity.