TY - JOUR

T1 - Влияние ингаляционных анестетиков на функциональное состояние печени пациентов с токсическим гепатитом при торакальных операциях во фтизиатрии

AU - Skorokhod, K. V.

AU - Volchkov, V. A.

AU - Li, V. F.

AU - Tronza, V. S.

N1 - Publisher Copyright: © 2021, Media Sphera. All rights reserved. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021

Y1 - 2021

N2 - Specific anti-tuberculosis (anti-TB) therapy is often accompanied by toxic hepatitis (29% of patients undergoing surgery for pulmonary tuberculosis). Objective. To evaluate the influence of inhaled anesthetics (sevoflurane and desflurane) on liver function in patients with toxic hepatitis after anti-TB chemotherapy undergoing surgery for pulmonary tuberculosis. Material and methods. The study included 71 patients with toxic hepatitis undergoing surgery for pulmonary tuberculosis. All patients were divided into 3 groups depending on anesthetic: desflurane (group D), sevoflurane (group S) and propofol (group P). The last one was control group. Serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TBil), alkaline phosphatase (ALP), γ-glutamyl transpeptidase (GGTP), lactate dehydrogenase (LDH), α-glutathione S-transferase (α-GST) were measured prior to surgery, in 1, 6, 24 hours, 7 and 14 days after surgery. Also, before induction, during the main stages of the operation, invasive monitoring of hemodynamics was performed using thermodilution technique by the PICCO device in order to exclude intraoperative ischemic injury of the liver. Results. Baseline ALT, AST, and α-GST exceeded the norm by 2-3 times. These values were comparable in all groups (p>0.05). A tendency to increase of α-GST in hour after surgery was observed in groups D and P, decrease of this enzyme — in group S (p>0.05). ALT and AST levels did not significantly increase in any group at all measurement points. ALP, GGTP and total bilirubin were normal throughout the study. LDH level was significantly higher after 24 hours in the desflurane group (p=0.02). Conclusion. Inhaled anesthetics (sevoflurane and desflurane) along with propofol do not worsen liver function in patients with toxic hepatitis in early and delayed postoperative period.

AB - Specific anti-tuberculosis (anti-TB) therapy is often accompanied by toxic hepatitis (29% of patients undergoing surgery for pulmonary tuberculosis). Objective. To evaluate the influence of inhaled anesthetics (sevoflurane and desflurane) on liver function in patients with toxic hepatitis after anti-TB chemotherapy undergoing surgery for pulmonary tuberculosis. Material and methods. The study included 71 patients with toxic hepatitis undergoing surgery for pulmonary tuberculosis. All patients were divided into 3 groups depending on anesthetic: desflurane (group D), sevoflurane (group S) and propofol (group P). The last one was control group. Serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TBil), alkaline phosphatase (ALP), γ-glutamyl transpeptidase (GGTP), lactate dehydrogenase (LDH), α-glutathione S-transferase (α-GST) were measured prior to surgery, in 1, 6, 24 hours, 7 and 14 days after surgery. Also, before induction, during the main stages of the operation, invasive monitoring of hemodynamics was performed using thermodilution technique by the PICCO device in order to exclude intraoperative ischemic injury of the liver. Results. Baseline ALT, AST, and α-GST exceeded the norm by 2-3 times. These values were comparable in all groups (p>0.05). A tendency to increase of α-GST in hour after surgery was observed in groups D and P, decrease of this enzyme — in group S (p>0.05). ALT and AST levels did not significantly increase in any group at all measurement points. ALP, GGTP and total bilirubin were normal throughout the study. LDH level was significantly higher after 24 hours in the desflurane group (p=0.02). Conclusion. Inhaled anesthetics (sevoflurane and desflurane) along with propofol do not worsen liver function in patients with toxic hepatitis in early and delayed postoperative period.

KW - Drug-induced liver injury

KW - Inhalation anesthesia

KW - Liver dysfunction and anesthesia

KW - Propofol

KW - Toxic hepatitis

UR - http://www.scopus.com/inward/record.url?scp=85105244047&partnerID=8YFLogxK

UR - https://www.mendeley.com/catalogue/39d8241c-c844-3df7-89a9-63a5e312a9b8/

U2 - 10.17116/anaesthesiology202102190

DO - 10.17116/anaesthesiology202102190

M3 - статья

AN - SCOPUS:85105244047

VL - 2021

SP - 90

EP - 97

JO - Russian Journal of Anesthesiology and Reanimatology /Anesteziologiya i Reanimatologiya

JF - Russian Journal of Anesthesiology and Reanimatology /Anesteziologiya i Reanimatologiya

SN - 0201-7563

IS - 2

ER -