Abstract
The mechanism for any hepatic damage produced by volatile anaesthetics remains unknown, although the subject has been studied extensively [18]. While there is some evidence of potential hepatotoxic properties of halothane [4], this case is still unsettled for enflurane and isoflurane [9, 11, 12]. Recently, a differential pathogenesis for both groups has been suggested, indicating a more chemotoxic mechanism for halothane and a mainly hypoxic mechanism for enflurane [10]. Possible factors involved in hepatic injury are presented in Fig. 1. According to Stevens et al. duration of anaesthesia contributes to toxicity [17]. Based on pharmacological rationale, isoflurane is occasionally quoted as the volatile agent of choice for prolonged anaesthesia [8, 14], although clinical studies on the subject are scarce.
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Jantzen, JP., Witton, P.K., Erdmann, K., Kleeman, P.P., Klein, A.M. (1986). Isoflurane During Prolonged Anaesthesia with Special Reference to Liver Function. In: Lawin, P., Van Aken, H., Puchstein, C. (eds) Isoflurane. Anaesthesiology Intensive Care Medicine/Anaesthesiologie und Intensivmedizin, vol 182. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-71230-2_8
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DOI: https://doi.org/10.1007/978-3-642-71230-2_8
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