Arslan M, Kurtipek O, Dogan A T, Unal Y, Kizil Y, Nurlu N, Kamaci S, Kavutcu M
Department of Anaesthesiology and Reanimation, Faculty of Medicine, Gazi University, Ankara, Turkey.
Singapore Med J. 2009 Jan;50(1):73-7.
Although most general anaesthesia procedures are performed without any complications, volatile agents may have adverse effects on various living systems. This study aimed to compare the effects of desflurane and enflurane on liver function.
40 patients, who were in the ASA I-III risk groups and were planned to undergo head and neck surgery of at least three hours' duration, were randomly divided into two groups: the desflurane (Group D) and enflurane groups (Group E). Venous blood samples (5 ml) of the patients were obtained before anaesthesia induction, in the postoperative first hour and on the first and seventh days. The samples were centrifuged and then stored at -80 degrees Celsius until the determination of glutathione S-transferase (GST) levels. For maintenance of anaesthesia in Group D, desflurane (6 percent) was used, while in Group E, enflurane (1.2 percent) was used.
GST levels were significantly higher in Group E in the postoperative first hour (p-value is 0.002), and on the first day (p-value is 0.025) and seventh day (p-value is 0.035), although there were no differences preoperatively (p-value is more than 0.05). When postoperative levels were compared with preoperative levels, the postoperative GST levels of Group E were significantly higher (first hour [p-value is 0.008], first day [p-value is 0.010], seventh day [p-value is 0.038]).
Subclinical hepatic injury after anaesthesia continues to be an issue of interest, particularly with the development of new, more sensitive methods of measuring GST levels. The increase in GST concentration after anaesthesia is thought to be a result of reduced hepatic blood flow. This study has shown that desflurane has fewer effects than enflurane on liver function tests in lengthy operations of up to 330 minutes.
尽管大多数全身麻醉手术都能顺利进行且无并发症，但挥发性麻醉剂可能会对各种生命系统产生不良影响。本研究旨在比较地氟烷和恩氟烷对肝功能的影响。
40例美国麻醉医师协会（ASA）I - III级风险组、计划接受至少持续三小时的头颈外科手术的患者，被随机分为两组：地氟烷组（D组）和恩氟烷组（E组）。在麻醉诱导前、术后第一小时以及术后第一天和第七天采集患者静脉血样本（5毫升）。样本经离心后，保存在-80摄氏度直至测定谷胱甘肽S - 转移酶（GST）水平。D组维持麻醉时使用地氟烷（6%），而E组使用恩氟烷（1.2%）。
尽管术前两组GST水平无差异（p值大于0.05），但E组术后第一小时（p值为0.002）、第一天（p值为0.025）和第七天（p值为0.035）的GST水平显著更高。当将术后水平与术前水平进行比较时，E组术后GST水平显著更高（第一小时[p值为0.008]、第一天[p值为0.010]、第七天[p值为0.038]）。
麻醉后亚临床肝损伤仍是一个受关注的问题，特别是随着新的、更敏感的GST水平测量方法的发展。麻醉后GST浓度的升高被认为是肝血流减少的结果。本研究表明，在地氟烷组（D组）和恩氟烷组（E组）中，在长达330分钟的长时间手术中，地氟烷对肝功能测试的影响小于恩氟烷。
