Granados Llamas L M, Navas Rivera E, Marenco de la Fuente M L, Balanza Ortiz R, Suárez Collazos F, Puente Egido J J
Departamento de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital de Rehabilitación y Traumatología, Ciudad Sanitaria Virgen del Rocío de Sevilla.
Rev Esp Anestesiol Reanim. 1999 Oct;46(8):350-3.
To measure and assess changes in plasma concentrations of alpha glutathione S-transferase (alpha-GST) during and after anesthesia with isoflurane, desflurane and propofol.
Study of 90 ASA I and II patients scheduled for lumbar back surgery under general anesthesia assigned randomly to one of three groups to receive anesthetic maintenance with isoflurane, desflurane or propofol. We measured plasma levels of alpha-GST, aspartate aminotransferase aspartate, alanine aminotransferase, alkaline phosphatase, pseudocholinesterase, gamma glutamyltransferase and total bilirubin at baseline and several times during and after surgery.
Changes in plasma levels of alpha-GST were detected in all three groups, the tendency to increase reaching its peak with the sample taken at the end of anesthesia. The ranges considered normal were not exceeded in any of the patients studied.
By measuring alpha-GST changes in plasma, we have detected signs of disturbance in hepatocellular integrity after anesthesia with all three maintenance agents used. However, the slight and transitory nature of the events confirms the scarce hepatotoxic potential of isoflurane, desflurane and propofol.
测量并评估异氟烷、地氟烷和丙泊酚麻醉期间及麻醉后血浆中α-谷胱甘肽S-转移酶（α-GST）浓度的变化。
对90例拟行全身麻醉下腰椎手术的美国麻醉医师协会（ASA）I级和II级患者进行研究，将其随机分为三组，分别接受异氟烷、地氟烷或丙泊酚进行麻醉维持。我们在基线时以及手术期间和术后的几个时间点测量了血浆中α-GST、天冬氨酸氨基转移酶、丙氨酸氨基转移酶、碱性磷酸酶、假性胆碱酯酶、γ-谷氨酰转移酶和总胆红素的水平。
所有三组均检测到血浆中α-GST水平的变化，麻醉结束时采集的样本中升高趋势达到峰值。在所研究的任何患者中均未超过正常范围。
通过测量血浆中α-GST的变化，我们发现在使用这三种维持麻醉药物进行麻醉后，肝细胞完整性存在紊乱迹象。然而，这些事件的轻微和短暂性质证实了异氟烷、地氟烷和丙泊酚的肝毒性潜力较小。
