Liver enzyme studies with continuous intravenous anaesthesia

Area of Science:

• Anesthesiology
• Hepatology
• Pharmacology

Background:

• Liver function tests are crucial for assessing perioperative health.
• Various anesthetic agents can impact liver function.
• Understanding anesthetic effects on the liver is vital for patient safety.

Purpose of the Study:

• To evaluate the impact of continuous infusion anesthetics (thiopentone, Althesin, etomidate) on liver function tests.
• To compare the hepatotoxic effects of different anesthetic agents.
• To compare anesthetic-induced liver function derangements with existing data on ketamine and balanced anesthesia.

Main Methods:

• Liver function tests were performed preoperatively and on postoperative days 3-5 and 13-15.
• Patients received continuous infusions of thiopentone, Althesin, or etomidate for intermediate operations.
• Data were compared with published studies on ketamine and balanced anesthesia techniques.

Main Results:

• Deranged liver enzyme activity was observed in 25-33% of patients.
• Althesin administration resulted in the most significant enzyme derangements.
• Ketamine showed similar effects on liver enzymes as Althesin.
• Pooled data indicated larger doses of intravenous anesthetics caused greater liver function derangement than balanced techniques.

Conclusions:

• Continuous infusion of thiopentone, Althesin, and etomidate can cause transient liver function derangements.
• Althesin and ketamine appear to have a more pronounced effect on liver enzymes compared to other agents studied.
• High-dose intravenous anesthesia may pose a greater risk to liver function than balanced anesthesia for similar surgical procedures.