[Influences of different anaesthetic techniques on serum levels of hepatic enzymes and of bilirubin (author's transl)].

The influence of four different types of anaesthesia -- halothane and enflurane inhalation anaestheis, neurolept analgesia and epidural analgesia with single shot technique -- on the serum levels of GOT, GPT, GLDH, LDH, AP, LAP, gamma-GT, total protein and bilirubin was examined in 104 comparable cases undergoing gynaecological surgery. A significant increase in GOT, GPT, GLDH, AP, and gamma-GT levels was observed between the 6th and 9th postoperative day with all types of anaesthesia. The serum levels remained elevated until the 15th postoperative day. There was no significant difference between the four types of anaesthesia as regarded their effects on the serum constituents investigated. The same applied to the serum CHE activity which reached a minimum on the 3rd postoperative day followed by a steady rise. The results indicate that the postoperative changes of the liver enzyme pattern are not related to the type of anaesthesia used. Bilirubin was elevated on the first postoperative day, then dropped rapidly and stayed below the pre-operative values until the 12th postoperative day. There was no difference between the four types of anaesthesia. Glucuronisation of bilirubin may be inhibited initially by the anaesthetic agents. The subsequent rapid fall of the bilirubin levels may be the result of enzyme induction.