Canadian Journal of Anaesthesia

, Volume 45, Issue 8, pp 753–756 | Cite as

Liver function after sevoflurane or isoflurane anaesthesia in neurosurgical patients

  • Tomoki Nishiyama
  • Takeshi Yokoyama
  • Kazuo Hanaoka
Reports of Investigation



Although both sevoflurane and isoflurane are thought to be less hepatotoxic than halothane or enflurane, recent case reports have described liver injury after sevoflurane or isoflurane anaesthesia. There are no studies comparing liver function after sevoflurane or isoflurane anaesthesia. The purpose of this study was to compare serum liver enzyme concentrations in patients receiving either sevoflurane or isoflurane anaesthesia prospectively.


Ninety patients scheduled for elective neurosurgery were studied. Serum concentrations of aspartame aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TBil), alkaline phosphatase (ALP), γ- glutamyl transpeptidase (GTP), and lactate dehydrogenase (LDH) were measured before and, 1, 2, 3, 7, and 14 days after either sevoflurane (45 patients) or isoflurane (45 patients) anaesthesia.


AST ALT and GTP increased peaking seven days after anaesthesia, especially in the isoflurane group. The numbers of patients with abnormal values in AST and ALT were not different in the isoflurane from that in the sevoflurane group. The increase in TBil peaked one day after anaesthesia in both groups.


Even in a small number of patients, isoflurane induced an elevation of serum levels of liver enzymes more frequently than did sevoflurane three to 14 days after anaesthesia.


Isoflurane Halothane Sevoflurane Enflurane Aspartame 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Quoique le sévoflurane et l’isoflurane soient censés être moins hépatotoxiques que l’halothane ou l’enflurane, on a rapporté de récents cas de lésion hépatique à la suite d’anesthésie avec le sévoflurane ou l’isoflurane. Aucune étude comparative de la fonction hépatique n’a été faite après une anesthésie avec le sévoflurane ou l’isoflurane. L’objectif de la présente étude était de comparer de façon prospective les concentrations sériques d’enzymes hépatiques chez les patients qui ont reçu une anesthésie avec le sévoflurane ou l’isoflurane.


Quatre-vingt-dix patients devant subir une neurochirurgie élective ont participé à l’étude. Les concentrations sériques d’aspartate-aminotransférase (AST), d’alanine-aminotransférase (ALT), de bilirubine totale (BilT), de phosphatase alcaline (PAL), de γ-glutamyl transpeptidase (GTP) et de lactate-déshydrogénase (LDH) ont été mesurées avant l’anesthésie, puis 1, 2, 3, 7 et 14 jours après l’anesthésie avec le sévoflurane (45 patients) ou avec l’isoflurane (45 patients).


LAST l’ALT et la GTP ont augmenté, surtout dans le groupe de l’isoflurane, avec une concentration maximale sept jours après l’anesthésie. Le nombre de patients présentant des valeurs anormales d’AST et d’ALT n’était pas différent selon les groupes d’isoflurane ou de sévoflurane. L’augmentation de BilT était à son maximum un jour après l’anesthésie dans les deux groupes.


Même dans un petit groupe de patients, l’isoflurane provoque une élévation des niveaux sériques d’enzymes hépatiques selon une plus grande fréquence que ne le fait le sévoflurane de 3 à 14 jours après l’anesthésie.


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Copyright information

© Canadian Anesthesiologists 1998

Authors and Affiliations

  • Tomoki Nishiyama
    • 1
  • Takeshi Yokoyama
    • 2
  • Kazuo Hanaoka
    • 1
  1. 1.Department of AnesthesiologyThe University of Tokyo, Faculty of MedicineTokyoJapan
  2. 2.Department of Anesthesiology and ResuscitologyKochi Medical CollegeKochiJapan

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