Changes in hepatocellular integrity during and after desflurane or isoflurane anaesthesia in patients undergoing breast surgery

Abstract

We have assessed hepatocellular integrity in patients anaesthetized with desflurane or isoflurane using glutathione transferase Alpha (GSTA) as a sensitive indicator. Volatile anaesthetic was administered to 72 women at 0.7 MAC for 25 min and thereafter at 1.0 MAC. GSTA was measured with a time-resolved immunofluorometric assay in serum samples. Mild or moderate increases in GSTA were found in approximately 40% of patients immediately after anaesthesia. In the desflurane group (n = 30) the increase in GSTA concentration was from a baseline value of the geometric mean of 1.3 μg litre-1 (95% confidence interval 0.9-1.9 μg litre-1) to a peak of 2.6 (1.8-3.8) μg litre-1. The corresponding increase in the isoflurane group (n = 31) was from 1.3 (0.9-1.9) μg litre-1 to 3.0 (2.2-4.2) μg litre-1. The change in GSTA concentration was significant in both groups but not between groups. No predictive factors for the increase in GSTA concentrations were found. Increased GSTA concentrations were not accompanied by increases in aminotransferases. We conclude that desflurane and isoflurane anaesthesia were associated with a mild subclinical disturbance of hepatocellular integrity.