| Clinical Evaluation of the Anesthetic Effects on the Liver Function . |
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Dae Ja Um, Ryung Choi, Dae Hyun Kim, Kwang Kil Lee |
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Department of Anesthesiology, Yonsei University Wonju Medical College, Wonju, Korea. |
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| Abstract |
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It is well known that some inhalation anesthetics and ancillary drugs are metabolized in the liver. Since this fact was reported (Read, 1672: Dripps, 1977) the influence of different anesthetics on the liver has been of great interest up to date. The most cause of postoperative hepatic dysfunction seems to be acute viral hepatitis, but there are some other causes such as anesthetic damage and untoward reactions to the drugs used in the intraoperative or postoperative periods(Bahior & Davidson, 1967: Bruce, 1972).
Halothane is usually a safe and effective inhalation anesthetic agent but on occation it has damaged the liver.
Many papers have reported these untoward reactions, and then attention began to be paid to other anesthetic agents. The author selected random samples of 100 adult femal patients who had lower abdominal operations at Wonju Christian Hospital between May 1982 to August 1982. Their physical status was ASA class l & ll, liver function tests were within normal limits and they had no previous history of operation or liver disease. They were divided into five groups according to the anesthetic agent used(halothane, ethrane, ether, Thalsmonal neuroleptanesthesia and lidocaine epidural anesthesia). The liver function tests were performed before surgery, and on the 1st, 3rd, 5th, and 7th postoperative days. The results were as follows. 1) BUN, total protein, albumin, globulin and total cholesterol were not significantly changed. 2) The values of SGOT &SGPT were slightly increased elevated on the first postopday, and on the 3rd day after operation and then gradually decreased. On the 7th day after operation they had returned to the preoperative levels. The changes of the values were within normal limits. 3) Alkaline phosphatase, total bilirubin and direct bilirubin were not significantly influenced by the anesthetic agents. It is suggested that the influence of variable anesthetic agent on the liver is not significant, and that the changes of the liver function tests were minimal, and the values of the tests have usually returned to normal by the 7th day after operation. |
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