Introduction. Tuberculosis and chronic viral hepatitis (CVH) are often associated infections in patients referred for surgical treatment.
Objective: evaluate the effect of inhaled (sevoflurane and isoflurane) and intravenous anesthetics (propofol) on the liver function of patients with CVH during surgical treatment of pulmonary tuberculosis.
Material and methods. The study included the results of examination and treatment of 105 patients with CVH who underwent lung resection for tuberculosis. All patients were divided into 3 groups depending on the type of anesthetic: isoflurane group (group I), sevoflurane group (group S), propofol group (group P). Patients were monitored for the following liver function parameters: alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TB), total protein, albumin, prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT), platelets. The indicators were evaluated before surgery, 24 hours later, on the 7th and 14th days after surgery.
Results. The initial level of ALT, AST, and total bilirubin was comparable in all three groups and was within normal values (p > 0.05). In all groups, there was a tendency to increase AST 24 hours after surgery, and the indicators of total bilirubin, platelets, APTT, INR, and PT remained within the normal range. In group S, the ALT level at 24 hours and 14 days after surgery was significantly higher than at baseline (p = 0.04; p = 0.05), but did not exceed the reference values. The level of albumin right after surgery was lower than the initial (p = 0.004). In group I, total protein was significantly lower after 24 hours than baseline (p = 0.0001). In group P, levels of total protein and albumin were lower at 24 hours after surgery (p = 0.0001; p = 0.04). Overall, among the three groups, there were significant differences on any of the parameters studied.
Conclusions. The inhaled anesthetics sevoflurane and isoflurane, along with propofol, do not have a negative effect on the functional state of the liver in patients with CVH during surgical treatment of pulmonary tuberculosis.
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About the authors
- Kseniya V. Skorokhod, Postgraduate, Anesthesiologist-Intensivist, ORCID
- Vladimir A. Volchkov, Dr. Med. Sc., Professor, Chief of Chair of Anesthesiology and Resuscitation, ORCID
- Vladimir F. Li, Head of the Department of Anesthesiology and Resuscitation ORCID