The effect of desflurane on liver function markers in infants and children- Report of a study and a pertinent case report

Background: In an open-labelled clinical trial, the effect of desflurane an aesthesia on liver function markers in paediatric patients was monitored. Methods: Fifty infants and children, 37 male, scheduled for elective cleft plate surgery were included in the study. Median age was 0.57 (0.25-5.45) y ears (range), mean desflurane exposure was 2.29+/-0.75 MAC-h. Function mark ers were determined within 24 h prior to and within 24-48 h after anaesthes ia. Complete data sets were available for total bilirubin 29, aspartate ami notransferase (ASAT) 36, alanine aminotransferase (ALAT) 35, and for alkali ne phosphatase (AP) 28. Pre- and postanaesthetic function tests were compar ed by means of Wilcoxon's matched-pairs test. Results: Only for AP could a statistically significant reduction of the pos tanaesthetic values be observed, while the other parameters showed no signi ficant changes. Postanaesthetic ASAT and ALAT were clearly reduced in three children who had unspecific highly elevated preanaesthetic values. After t he study, this observation could be repeated in at least one child, who rec eived a further anaesthesia with desflurane within 3 months. Conclusion: The data suggest that desflurane does not affect excretory or s tructural liver integrity in infants and children.