| Popis: |
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. |
