European Journal of Biomedical and Pharmaceutical Sciences

EFFECT OF SEVOFLURANE ON POST-OPERATIVE HEPATIC FUNCTION IN OBESE AND NON-OBESE PATIENTS UNDERGOING GASTRIC SURGERIES

Kavita*, Dr. Shyamal Koley

ABSTRACT

Background: Sevoflurane is considered to have lower organ toxicity and is widely used as an inhalational anaesthetic in gastric surgeries, including bariatric procedures and radical gastrectomies. Objectives: This study aimed to evaluate the effect of sevoflurane on postoperative hepatic function in obese and non-obese patients who underwent laparoscopic and open abdominal surgeries, retrospectively. Methods: Sevoflurane, a major anaesthetic agent, is characterized by its rapid onset of action and rapid elimination. Due to its fast induction and minimal airway irritation, it is suitable for both induction and maintenance of anaesthesia. Results: In morbidly obese patients, AST, ALT, GGT, and LDH levels increased significantly compared with non-morbidly obese patients. Total bilirubin (TBill) rose gradually, peaking on day 7 after anaesthesia, while GGT also showed a significant rise by day 7. LDH, AST, and ALT reached their highest levels in the immediate postoperative recovery room, followed by a gradual decline towards day 7. No increase in ALP was observed throughout the study. Among morbidly obese patients, TBill reached 2 mg/dL in one case, LDH values ranging from 900 to 2110 IU/L were seen in 7 patients, and AST/ALT levels between 200 and 660 IU/L were noted in 4 patients. In non-obese patients, only AST and LDH increased transiently in the recovery period. Importantly, no cases of postoperative hepatitis or liver disease were reported. Conclusion: Sevoflurane anaesthesia is associated with a temporary rise in liver enzymes in morbidly obese patients. These elevations were statistically significant but not clinically relevant, as they did not result in postoperative hepatitis or liver failure. The mechanism underlying this enzyme increase remains unclear. 

Keywords: Sevoflurane, Gastric operations, Laparoscopic procedures, Open abdominal surgery, Hepatic function, Liver enzymes, General anaesthesia, Inhalational agent, Hemodynamic stability.