A Comparative Study between Inhalation Anesthesia using Sevoflurane and Total Intravenous Anesthesia by Propofol in Patients with Elevated Liver Enzymes

Abstract

Background: Clinical anesthesia involves use of sevoflurane and propofol, both of which have been shown to protect liver function. To the best of our knowledge, this is the first study conducted in Zagazig University hospitals comparing the effects of sevoflurane and propofol on the liver function after surgery in patients who would be under general anesthesia and had preoperatively increased liver enzyme levels.Aim: To evaluate the effects and side effects of total intravenous anesthesia (TIVA) against inhalational anesthesia (sevoflurane) versus propofol on postoperative liver function in patients undergoing general anesthesia who have preoperatively increased liver enzyme levels.Methods: 80 patients with preoperatively increased liver enzyme values who presented to the Zagazig University hospitals participated in this prospective, randomized clinical trial. The patients were divided into two equal groups at random using a computer randomization table. Group (P): Propofol group and Group (S): Sevoflurane group.Results: There was a significant higher ALT and AST liver enzymes at H1 (12 hours postoperative),H2 (24hours postoperative), Peak value within 3 days in Group S compared to Group P (p<0.05). In addition, comparing to basal ALT and AST at (H0), the Mean Difference and percent of change of ALT and AST at (H1) value, ALT and AST at (H2) value, ALT and AST Peak value within 3day, were significantly higher in Group S compared to Group P.Conclusion: Our results suggest that propofol may be a safer anesthetic option than sevoflurane for the maintenance of normal postoperative liver function in this vulnerable patient population.