[Effects of enflurane and halothane on hepatic function in biliary surgery]

Area of Science:

• Anesthesiology
• Hepatology
• Surgical Oncology

Background:

• Hepato-biliary surgery requires careful anesthetic selection to minimize hepatic complications.
• Volatile anesthetics like enflurane and halothane have known effects on liver function.
• Assessing the impact of anesthetics on liver enzymes is crucial for patient outcomes.

Purpose of the Study:

• To compare the effects of enflurane and halothane on hepatic function in patients undergoing hepato-biliary surgery.
• To evaluate variations in specific liver enzymes post-anesthesia.
• To determine the preferable anesthetic agent for patients with preoperative hepatic abnormalities.

Main Methods:

• A comparative study involving 80 patients undergoing hepato-biliary surgery.
• Patients were randomized into two groups, 40 each, receiving either enflurane or halothane anesthesia.
• Blood samples were analyzed for gamma GT, bilirubin, SGOT, SGPT, alkaline phosphatase, and LDH on the day before surgery and on days 1, 2, and 5 post-operation.

Main Results:

• Both anesthetics caused an increase in certain liver enzymes (BD, SGPT, LDH).
• The elevation in liver enzymes was less pronounced with enflurane compared to halothane.
• Patients with preoperative hepatic abnormalities showed a more significant increase in enzymes, particularly with halothane.

Conclusions:

• Enflurane demonstrates a more favorable profile regarding hepatic function compared to halothane in hepato-biliary surgery.
• Enflurane is the preferred anesthetic choice for patients with pre-existing liver conditions undergoing these procedures.
• Monitoring liver function through enzyme levels is essential following anesthesia in hepato-biliary surgery.