O efeito dos anestésicos inalatórios halotano e sevoflurano em um modelo experimental de lesão hepática

Abstract

Background and objectives: Hepatic injury after inhalational anesthesia is controversial. Studies have suggested that inhalational agents generate an immune response that can provoke hepatic injury. The objective of this study was to analyze the effects of the inhalational agents halothane and sevoflurane on the liver of rats submitted to hypoxia and reperfusion. Methods: Thirty Wistar rats, pretreated with 0.1% phenobarbital for 5 days, with discontinuation of the drug 24 hours before the experiment to cause hepatic injury, were used. Animals were distributed in five groups of six rats each. The control group (C) did not receive any treatment; in the F group, phenobarbital was used to induce hepatic injury; the Hypoxia group was submitted to 14% oxygen (O 2); the H group received 1% halothane and 14% O 2 ; and the S group received 2% sevoflurane and 14% O 2. Twenty-four hours after exposure to the gases, blood samples were collected to evaluate transaminases (AST and ALT), and liver samples were collected for histological evaluation. Kruskal-Wallis Analysis of Variance and the Newman-Keuls test were used. Results: Enzymatic activity mean values of AST (280.33, for halothane, 181, for sevoflurane) and ALT (235 for halothane, and 48.33, for sevoflurane) did not show significant differences, and all groups showed elevated values. Compared to halothane on optical microscopy, sevoflurane had lower indices of morphologic changes with p = 0.045, for steatosis, p = 0.0075, for inflammatory infiltrate, and p = 0.0074, for necrosis. Conclusions: Compared to the halothane group, sevoflurane did not show injuries of the liver parenchyma on optical microscopy.

Risco ocupacional com anestésico inalatório: uma discussão a partir da opinião da classe médica

“…Os anestésicos inalatórios são os fármacos mais utilizados para manutenção da anestesia geral, demonstraram em estudos epidemiológicos que se inalados de forma crônica, em baixas concentrações, aumentam a incidência de doença hepática e determinados tipos de leucemia, bem como de abortos espontâneos e malformações congênitas, comparados com grupos similares de indivíduos não expostos a agentes anestésicos 3,4,5,6 . Os anestésicos mais utilizados no ocidente são: halotano, enflurano, isoflurano, sevoflurano e óxido nitroso 7 .…”