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Abstract : |
This study presents the liver affection following low flow Sevoflurane anesthesia, total intravenous propofol anesthesia and regional epidural ropivacaine anesthesia in patients undergoing hysterectomy by using glutathione-S-transferase (أƒإ½أ‚آ±-GST) as a sensitive indicator of hepatocellular integrity as compared to the conventional liver enzypostoperative) and the measurements of blood glucose level, renal function tests, conventional liver enzymes and serum أƒإ½أ‚آ±-GST were done for all subjects. The results showed that, the conventional liver enzymes did not show any significant changes between the three studied groups, while the أƒإ½أ‚آ±-GST showed statistical significant difference between the three studied groups in the 2 h postoperative. أƒإ½أ‚â€ک GST concentration was significantly increased in group I in the 2 h postoperativemes. The study conducted on 45 healthy patients ASA I or II, scheduled for abdominal hysterectomy were randomly allocated into three equal groups. Group I received low flow Sevoflurane anesthesia, Group II received total intravenous propofol anesthesia and group III received regional epidural ropivacaine anesthesia. Three blood samples were drawn from each patient (preoperative, 2 and 24 h samples as compared to preoperative values and two other groups. While, in group II and group III there were no significant increase as compared to the preoperative values, although in group III the concentration of أƒإ½أ‚آ±-GST decreased but not significantly in the 2 h postoperative sample mostly due to hydration of the patients by the preloading fluid. The finding from this study suggest that, the epidural anesthesia has the least effect on liver functions especially when it was assessed by أƒإ½أ‚آ±-GST which is more specific and sensitive index for hepatic injury than the conventional liver enzymes. Epidural anesthesia should be considered as the anesthetic technique of choice forabdominal hysterectomy. Propofol also led to minimal effect on أƒإ½أ‚آ±-GST and a better quality of recovery than sevoflurane anesthesia, which caused mild elevation in GST and this may limit its use in patients with hepatic dysfunction., |
