Assessment of Hepatic, Respiratory and Metabolic Derangements in Patients During and After Isoflurane Anesthesia in Surgical Operations

Document Type : Original Article


Worldwide, general anesthetics and sedatives are used in hundreds of thousands of patients every
year during surgical operations, invasive procedures, and imaging studies. Isoflurane is the commonest
inhalational anesthetic used nowadays. This study was conducted to evaluate the respiratory, metabolic
and hepatic impacts of isojlurane exposure by biochemical assays to estimaJe respiraJory and metabolic
parameters (pH, Pco2, Po2, bicarbonate, glucose and lactate) and liver junction tests (AST, ALT and Al
pha-GST). The current study was carried out on apparently healthy 40 male and female patients who were classified into two major groups; Group 1 (control) and Group Il who exposed to isoflurane anes
thetic for 4 hours during vitrectomy operation in ophthalmic operation theatre, Kasr El Aini Hospital. Ar·
terial and venous blood samples were taken at I, 2,3 and 4 h time points during isoflurane exposure and
at 1, 2,3 and 4 h time points after discontinuation of isoflurane to assess respiratory and metabolic parameters (pH, Pco2 and Po2, bicarbonate, glucose and i.AcUJte ) in addition to liver function tests (AST. ALT and Alp/UI-GST). Isojlurane exposure led to respiratory and metabolic derangements in group /1.
There was significant reduction in pH, bicarbonate and blood glucose level with significant elevation in
lactate and PaCoz through the 2nd hour, 3rd hour and 4th hour during exposure time. After cessation of
isojlurane, metabolic markers gradually nor11Ullized in group II. Pa02 was stable in both groups with no
significant clulnges as both groups were oxygenated. As regard liver function zests, significant elevation in serum level of A.ST, ALT and Alp/UI-GST were recorded in group II through the 3rd hour and 4111 hour
during exposure time. Gradual decrease of their le:vels through the 3rd hour and 4th hour during post op
era.Jive period was noticed. The previously declared results revealed that isoflurane possess hazardous ef
fects 011 general health. It causes liver, metabolic 011d respiratory dysfunction. Thus repeated anesthesia
within a short period of time should be approached with caution since the risk of hepatotoxicity, metabol
ic and respiratory dysfunction is suspected.