Plasma Glutathione S-Transferase Concentration as a Measure of Hepatocellular Integrity Following a Single General Anaesthetic With Halothane, Enflurane or Isoflurane

Abstract

The plasma concentration of hepatic glutathione S-transferase (GST) was measured in matched groups of patients who received halothane, enflurane or isoflurane anaesthesia for elective minor surgery. The GST concentrations increased significantly at 3 h after anaesthesia in patients who received halothane or enflurane, but not in patients who were given isoflurane. A secondary increase in GST concentration, at 24 h, was seen in a small number of individuals who received halothane or enflurane. Abnormal GST concentrations were found in 50% of patients following halothane anaesthesia, 20% following enflurane and 11% after isoflurane. The small but significant increases in GST concentrations in patients receiving halothane or enflurane suggests an impairment of hepatocellular integrity following the administration of these anaesthetics. In contrast, isoflurane anaesthesia did not appear to be associated with this effect.

Comparison of plasma α glutathione S‐transferase concentrations during and after low‐flow sevoflurane or isoflurane anaesthesia

“…Plasma α GST concentrations in patients anaesthetized with low‐flow isoflurane did not significantly increase during the study period. This finding is consistent with previous studies, which report no significant increase in plasma α GST concentrations after isoflurane anaesthesia (15–17, 19). In addition, there was no significant difference between the sevoflurane and isoflurane groups as assessed by plasma ALT concentrations.…”

“…Plasma α glutathione S‐transferase (GST) GST is a more sensitive and specific marker of hepatocellular damage than is aminotransferase activity and correlates better with hepatic histology (10–13). Clinical investigations of the effects of anaesthetics on hepatocellular integrity as assessed by plasma α GST concentrations indicate that plasma α GST concentrations increase transiently after anaesthesia with halothane (14–17), but not isoflurane (15–18) or propofol anaesthesia (18, 19).…”

Effects of sevoflurane and isoflurane anesthesia on arterial ketone body ratio and liver function

“…Previous clinical studies have compared liver function between sevoflurane or isoflurane anesthesia and halothane or enflurane anesthesia by measuring serum levels of liver enzymes (1)(2)(3). However, there have been no reports comparing sevoflurane with isoflurane anesthesia.…”

A Mouse Model of Severe Halothane Hepatitis Based on Human Risk Factors

“…Labeled in picture are central vein (CV) and portal triad (PT). hepatotoxic IADRs in humans (Hussey et al, 1988). In female BALB/cJ mice, halothane exposure caused dosedependent hepatotoxicity, whereas ALT activity was not increased at doses of isoflurane up to 30 mmol/kg (Fig.…”