The effect of isoflurane or propofol anaesthesia on liver injury after partial hepatectomy in cirrhotic patients

Abstract

This study compared the effect of isoflurane or propofol anaesthesia on postoperative hepatocellular injury, liver function and pro-inflammatory cytokine concentrations in 60 cirrhotic patients, after partial hepatectomy using Pringle's manoeuvre. In the isoflurane group postoperatively, both mean (SD) aspartate aminotransferase (day 1: 197 (123) U.l -1 vs 261 (143) U.l -1; p = 0.01; day 3: 465 (258) U.l -1 vs 578 (311) U.l -1; p = 0.02) and alanine aminotransferase (day 1: 575 (312) U.l -1 vs 714 (434) U.l -1; p = 0.04 and day 3: 776 (443) U.l -1 vs 898 (746) U.l -1; p = 0.03) were significantly lower compared with the propofol group. Mean (SD) postoperative white cell count was significantly lower with isoflurane than propofol (day 1: 12 (4) × 10 3.mm -1 vs 16 (4) × 10 3.mm -1; p = 0.01 and day 3: 10 (6) × 10 3.mm -1; vs 14 (4); p = 0.01). Tumour necrosis factor-α (day 1) and interleukin-1 (days 1 and 3) concentrations were significantly lower with isoflurane. Compared with propofol, isoflurane is associated with an attenuated postoperative inflammatory response and less postoperative hepatocellular injury in patients having this procedure. © 2010 The Association of Anaesthetists of Great Britain and Ireland.