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Is enflurane hepatotoxic?

E I Eger, E A Smuckler, L D Ferrell

    Anesthesia and Analgesia
    |January 1, 1986
    PubMed
    Summary
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    This study found no clear link between enflurane anesthesia and liver injury in 88 patients. While some cases showed possible connections, the data suggest severe hepatic injury from enflurane is extremely rare.

    Area of Science:

    • Anesthesiology
    • Hepatology
    • Clinical Toxicology

    Background:

    • Hepatic injury is a potential adverse effect of anesthetic agents.
    • Enflurane, a volatile anesthetic, has been suspected as a cause of liver injury.

    Purpose of the Study:

    • To investigate the causal relationship between enflurane anesthesia and subsequent hepatic injury.
    • To determine the incidence and characteristics of liver injury potentially associated with enflurane.

    Main Methods:

    • Retrospective analysis of 88 cases with hepatic injury following enflurane anesthesia.
    • Evaluation of confounding factors and clinical presentation in each case.
    • Review of liver pathology in affected patients.

    Main Results:

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    • Data were insufficient to confirm causality in 30 cases.
    • In 43 cases, other known causes of hepatic injury were present.
    • In 15 cases, no other clear cause was identified, but no consistent pathology was found.
    • A suggested syndrome for enflurane-induced injury was present in both 'possible' and 'unlikely' groups without significant difference.

    Conclusions:

    • The study does not demonstrate a causal relationship between enflurane anesthesia and liver injury.
    • Severe hepatic injury attributed to enflurane anesthesia appears to be an extremely rare event.