Comparative Effect of Desflurane and Sevoflurane on Liver Function Tests of Patients with Impaired Hepatic Function Undergoing Cholecystectomy: A Randomized Clinical Study

Background And Aim: Desflurane and sevoflurane are the most common volatile anesthetics used during laparoscopic and hepatic surgery. The objective of the study was to evaluate the effect of desflurane and sevoflurane in patients with elevated preoperative liver functions undergoing laparoscopic cholecystectomy.

Methods: The study was a randomized study and included 162 patients classified randomly into two groups: Desflurane group: The patients received desflurane (end-tidal concentration 4%-6%) as an inhalational agent during the whole procedure. Sevoflurane group: The patients received sevoflurane (end-tidal concentration 2%-4%) as an inhalational agent during the whole procedure. The investigations included serum level of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma-glutamyltransferase (GGT), and total bilirubin. The values were serially collected at the following timepoints; T0:at the preoperative period, T1:directly after surgery, T2:1 postoperative day, T3:2 postoperative day, T4:3 postoperative day, T5:5 postoperative day, T6:7 postoperative day, and T7:10 postoperative day. The statistics were described in terms of mean ± standard deviation, frequencies, and percentages.

Results: The preoperative liver enzymes and total bilirubin were higher than the normal range in patients of the two groups. Postoperatively, there was a decrease in the AST and ALT with desflurane more than sevoflurane from T1 to T6( < 0.05). The ALP, GGT, and bilirubin decreased in patients of the two groups, but the comparison was insignificant ( > 0.05).

Conclusion: The desflurane is a safe inhalational volatile for maintenance of anesthesia in patients with impaired liver function undergoing laparoscopic cholecystectomy. It was associated with a decrease in the liver enzymes more than the sevoflurane.