Analysis of Hepatotoxicity Following Surgery with General Anesthesia

Suh, In Ok; Bae, Chung In; Cheun, Jae Kyu

Abstract

Postoperative hepaotoxicity may develope as a result of many causes. These poasble cau may include direct injury to the liver cella due to anesthetic drugs such as halothane, chronic liver disease, viral hepatitis, sepsis, severe burns, pregnancy, drug administration and transfusion. We had seven cases of acute hepatitis following surgery for the past 6 months. CASE 1: A 26-year-old male had an operation for maxillar fracture under isoflurane anesthesia. The preoperative liver enzyme (SGOT, SGPT) were elevated but other tests were within normal range. He developed high fever, marked elevation of SGOT, SGPT, upper abdominal pain and nausea on the 7th postoperative day. He died of acute respiratory and renal failure on the 23 rd postoperative day. CASE 2: A 55-year-old woman had an operation for cervical spondylosis under halothane anesthesia. She developed high fever, headache and leukocytosis on the 12th postoperative day. Liver function tests showed marked elevation of SGOT, SGPT, bilirubin and hypoalbuminemia on the 17th day. She died of acute respiratory failure on the 30th postoperative day. CASE 3: A 53-year-old woman had an operation for epidermal cyst under halothane anesthesia. On the 12th postoperative day she developed high fever, skin rash, marked elevation of SGOT, SGPT and leukopenia. She recovered gradually from hepatitis and went home in good health on the 30th postoperative day. CASE 4: A 68-year-old man had an operation for oral cancer under enflurane anesthesia. On the 16th postoperative day, liver function tests showed elevation of SGOT, SGPT and leukopenia, He gradually recovered on the 19th postoperative day. CASE 5: A 64-year-old woman had an operation for MCA aneurysm under enflurane anesthesia. He developed hypotension on the 20th postoperative day and respiratory difficult and marked elevation of SGOT, SGPT, BUN, creatinine, and generalized edema on the 22nd day. She recovered gradually and went home in good health on the 45th postoperative day. CASE 6: A 23-year-old woman had an operation for mandible fracture under enflurane anesthesia. The preoperative liver function tests showed a mild elevation of SGOT, SGPT, ALP. She recovered gradually and went home in good health on the 30th postoperative day. CASE 7: A 19-year-old woman had an operation for mandible fracture under halothane anesthesia. On the 30th postoperative day, she developed jaundice and marked elevation of SGOT, SGPT. She recovered gradually and went home in good health on the 55th postoperative day.