The effects of N-acetylcysteine on hepatic function during isoflurane anaesthesia for laparoscopic surgery patients

Abstract

Introduction: Although most general anaesthesia procedures are performed without any complications, volatile agents may have adverse effects on various living systems. This study aims to compare the antioxidant effects of isoflurane and N-acetylcysteine (NAC) on liver function.

Methods: Forty-one patients in the ASA I-II risk groups, who were scheduled to undergo gynaecologic laparoscopy, were randomly divided into two groups: The placebo (group P, n=21) and the NAC group (group N, n=20). In both groups, anaesthesia was maintained with 1-2% isoflurane in 50% Oxygen-50% N(2)O at 6 l/min, also administered by inhalation. Venous blood samples were obtained before anaesthesia induction, and then in the postoperative 1(st) hour and at the 24(th) hour. The samples were centrifuged and serum levels of glutathione S-transferase (GST), malondialdehyde (MDA), aspartate amino transferase (AST), alanine amino transferase (ALT), lactate dehydrogenase (LDH), gamma glutamyltranspeptidase (GGT), prothrombin time (PT), activated partial thromboplastin time (aPTT) and international normalised ratio were determined.

Results: GST levels were significantly higher in group N than in group P in the postoperative 1(st) hour. Postoperative values of GST in the two groups were higher when compared to preoperative values (P<0.05). When postoperative levels were compared with preoperative levels, the postoperative MDA levels of group N were significantly higher (P<0.05). Levels of AST, ALT, GGT and LDH in both groups revealed significant decreases at the postoperative 1(st) hour and postoperative 24(th) hour compared to preoperative values (P<0.05, P<0.001). PT values were significantly higher in both groups in the postoperative 1(st) hour and 24(th) hour (P<0.05, P<0.001), although there were no differences in aPTT levels.

Conclusion: Our results showed that liver functions were well preserved with administration of NAC during anaesthesia with isoflurane. Isoflurane with NAC has lesser effect on liver function tests compared to isoflurane alone.

Keywords: Isoflurane; N-acetylcysteine; liver function tests.