Baden J M, Kundomal Y R, Luttropp M E, Maze M, Kosek J C
Anesth Analg. 1985 Dec;64(12):1183-8.
Halothane, enflurane, isoflurane, and fentanyl were examined for their potential to exacerbate liver dysfunction in rats with preexisting cirrhosis. Male Wistar rats given sodium phenobarbital for 2 weeks are assigned randomly to two groups. One group (cirrhotic) was exposed by inhalation to carbon tetrachloride (CCl4) in air at weekly intervals for 12 weeks to induce cirrhosis. The other group (noncirrhotic) was handled similarly but received air only. Five weeks after the last exposure to CCl4, cirrhotic and noncirrhotic rats were given three hours of 1 MAC halothane, enflurane, or isoflurane in 50% oxygen, or 350 micrograms fentanyl per kg of body weight and 50% oxygen, or 50% oxygen only. Blood gas tensions and blood glucose levels were measured before, during, and at the end of exposure. Forty-eight hours after exposure, serum chemistries were measured in each rat for comparison with preexposure values. Rats were then killed by CO2 overdose, and liver, kidney, and testis were prepared for microscopic examination. Enflurane, isoflurane, and halothane, but not fentanyl, produced mild respiratory acidosis and no change in serum glucose levels. All anesthetics resulted in a mild but similar degree of acute liver dysfunction as indicated by small increases in SGOT or SGPT in both cirrhotic and noncirrhotic rats. Liver histology revealed mild to moderate portal cirrhosis with fibrosis and well-developed micronodules in rats exposed to CCl4, but no superimposed acute hepatocellular damage was noted. It is concluded that all the anesthetics used in this study were associated with the same minimal degree of postanesthetic hepatic dysfunction and that the dysfunction was similar in both cirrhotic and noncirrhotic rats.
研究了氟烷、恩氟烷、异氟烷和芬太尼在已有肝硬化的大鼠中加重肝功能障碍的可能性。给雄性Wistar大鼠服用苯巴比妥钠2周,然后随机分为两组。一组(肝硬化组)每周通过吸入空气-四氯化碳(CCl4)12周以诱导肝硬化。另一组(非肝硬化组)处理方式相同,但仅吸入空气。最后一次接触CCl4 5周后,给肝硬化和非肝硬化大鼠吸入3小时含50%氧气的1 MAC氟烷、恩氟烷或异氟烷,或每千克体重注射350微克芬太尼加50%氧气,或仅吸入50%氧气。在接触前、接触期间和接触结束时测量血气张力和血糖水平。接触后48小时,测量每只大鼠的血清化学指标,与接触前的值进行比较。然后通过过量二氧化碳处死大鼠,制备肝脏、肾脏和睾丸用于显微镜检查。恩氟烷、异氟烷和氟烷,但芬太尼未导致轻度呼吸性酸中毒,血清葡萄糖水平无变化。所有麻醉剂均导致轻度但相似程度的急性肝功能障碍,表现为肝硬化和非肝硬化大鼠的血清谷草转氨酶(SGOT)或谷丙转氨酶(SGPT)略有升高。肝脏组织学显示,接触CCl4的大鼠有轻度至中度门静脉性肝硬化伴纤维化和发育良好的小结节,但未发现叠加的急性肝细胞损伤。结论是,本研究中使用的所有麻醉剂均与相同程度的麻醉后肝功能障碍相关,且肝硬化和非肝硬化大鼠的功能障碍相似。