Effect of sevoflurane anaesthesia on plasma concentrations of glutathione S-transferase

Abstract

To assess the effect of sevoflurane anaesthesia on hepatocellular integrity, we measured plasma concentrations of glutathione S-transferase (GST) before anaesthesia and 1, 3, 6 and 24 h after the end of anaesthesia in 41 healthy, Japanese patients undergoing elective, body surface surgery. Sevoflurane (approximately 1.0 MAC) was delivered in 50-66% nitrous oxide in oxygen via a circle system, with a fresh gas flow of 6 litre min-1. Ventilation was spontaneous in all patients. Mean duration of anaesthesia was 101 min. Concentrations of GST increased significantly 1 h after the end of anaesthesia (P = 0.0075), but this was not significantly different from preoperative concentrations at 3, 6 and 24 h. Three patients developed a large secondary increase in GST concentrations at 24 h. The increase observed at 1 h was probably a result of reduced total liver blood flow; the mechanism for the secondary increase at 24 h is unclear but the possibility that products of sevoflurane biotransformation are responsible cannot be excluded.

Serum glutathione S‐transferase concentrations and creatinine clearance after sevoflurane anaesthesia

“…This is in keeping with a recent study of Japanese patients undergoing body surface surgery which showed an increase in plasma concentration of GST at 1 h after surgery [16]. However, there was no control group in that study.…”

The effect of desflurane on liver function markers in infants and children

“…Altered hepatic blood flow may result in transient liver impairment detected by changes of glutathione S‐transferase occurring a few hours after anaesthesia. Interaction with compounds of highly metabolised volatile anaesthetics may explain liver impairment appearing about 24 h after anaesthesia (20). Severe injury occurring in this period may affect cellular structure and should be reflected in ASAT and ALAT.…”

Glutathione S-transferase as a toxicity indicator in general anesthesia: genetics and biochemical function

“…Disturbance of hepatocellular integrity as a result of anesthesia with halothane, enflurane, sevoflurane, desflurane, propofol, and isoflurane was shown and described many times [3][4][5]. Several studies analyzing the liver function indicate the importance of class α-GST enzyme or its dominating fraction called "basic form" (GST B1), as opposed to the entire molecule of the GST enzyme.…”

“…Unexpected and adverse reactions in their activity may occur, for example, bradycardia (5%-23%), hypotension, ophthalmic or motor disorders, and propofol infusion syndrome [2]. Disturbance of hepatocellular integrity as a result of anesthesia with halothane, enflurane, sevoflurane, desflurane, propofol, and isoflurane was studied [3][4][5]. Serum and urine GST measurements are widely used in the studies as toxicity indicator of anesthetics in the liver and in the kidney [6][7][8].…”