Effects of propofol versus isoflurane on liver function after open thoracotomy

Asian Cardiovasc Thorac Ann. 2015 Mar;23(3):292-8. doi: 10.1177/0218492314551972. Epub 2014 Sep 15.

Abstract

Background: Anesthetic agents and type of surgery may contribute to postoperative hepatic injury. Inhalational anesthetics have been associated with hepatic dysfunction after surgery, however, propofol is expected to have a lower potential for postoperative liver injury. This prospective double-blind randomized clinical study was planned to determine whether postoperative liver function differs after anesthesia with isoflurane and total intravenous anesthesia with propofol in patients undergoing a posterolateral thoracotomy.

Methods: Eighty-eight patients in American Society of Anesthesiologists physical status 1 or 2, aged 16-60 years, and scheduled for an elective posterolateral thoracotomy, were randomly assigned to an anesthetic protocol: propofol (n = 44) or isoflurane (n = 44). Induction of anesthesia was similar in both groups. Serum levels of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, lactate dehydrogenase, total bilirubin, and γ-glutamyltransferase were measured before induction of anesthesia and on the first and third days after either propofol or isoflurane anesthesia.

Results: Mild changes in postoperative serum levels of liver enzymes were significant within each group but the differences between groups were not significant.

Conclusions: Propofol and isoflurane anesthesia have a comparable minor effect on liver function after an elective posterolateral thoracotomy.

Keywords: Anesthetics; inhalation; isoflurane; liver function tests; postoperative complications; propofol; thoracotomy.

Publication types

  • Clinical Study
  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Alanine Transaminase / blood
  • Alkaline Phosphatase / blood
  • Anesthesia, Intravenous / adverse effects*
  • Anesthetics, Inhalation / administration & dosage
  • Anesthetics, Inhalation / adverse effects*
  • Aspartate Aminotransferases / blood
  • Bilirubin / blood
  • Double-Blind Method
  • Female
  • Humans
  • Isoflurane / administration & dosage
  • Isoflurane / adverse effects*
  • Isoflurane / pharmacology
  • L-Lactate Dehydrogenase / blood
  • Liver Diseases / blood*
  • Liver Diseases / etiology
  • Male
  • Middle Aged
  • Postoperative Complications / blood
  • Postoperative Complications / etiology*
  • Propofol / administration & dosage
  • Propofol / adverse effects*
  • Propofol / pharmacology
  • Prospective Studies
  • Random Allocation
  • Thoracotomy / methods
  • Young Adult
  • gamma-Glutamyltransferase / blood

Substances

  • Anesthetics, Inhalation
  • Isoflurane
  • L-Lactate Dehydrogenase
  • gamma-Glutamyltransferase
  • Aspartate Aminotransferases
  • Alanine Transaminase
  • Alkaline Phosphatase
  • Bilirubin
  • Propofol