Effects of propofol versus isoflurane on liver function after open thoracotomy

Abstract

Background Anesthetic agents and type of surgery may contribute to postoperative hepatic injury. Inhalational anesthetics have been associated with hepatic dysfunction after surgery, however, propofol is expected to have a lower potential for postoperative liver injury. This prospective double-blind randomized clinical study was planned to determine whether postoperative liver function differs after anesthesia with isoflurane and total intravenous anesthesia with propofol in patients undergoing a posterolateral thoracotomy. Methods Eighty-eight patients in American Society of Anesthesiologists physical status 1 or 2, aged 16–60 years, and scheduled for an elective posterolateral thoracotomy, were randomly assigned to an anesthetic protocol: propofol ( n = 44) or isoflurane ( n = 44). Induction of anesthesia was similar in both groups. Serum levels of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, lactate dehydrogenase, total bilirubin, and γ-glutamyltransferase were measured before induction of anesthesia and on the first and third days after either propofol or isoflurane anesthesia. Results Mild changes in postoperative serum levels of liver enzymes were significant within each group but the differences between groups were not significant. Conclusions Propofol and isoflurane anesthesia have a comparable minor effect on liver function after an elective posterolateral thoracotomy.