alexa Abstract | Hepatotoxicity after Sevoflurane Exposure in a Patient with Chronic Hepatitis C: A Case Report

Annals of Clinical and Laboratory Research
Open Access

OMICS International organises 3000+ Global Conferenceseries Events every year across USA, Europe & Asia with support from 1000 more scientific Societies and Publishes 700+ Open Access Journals which contains over 50000 eminent personalities, reputed scientists as editorial board members.

Open Access Journals gaining more Readers and Citations

700 Journals and 15,000,000 Readers Each Journal is getting 25,000+ Readers

This Readership is 10 times more when compared to other Subscription Journals (Source: Google Analytics)

Research Article Open Access


Sevoflurane is considered a safe inhaled anesthetic of choice in patients with liver disease. Compared to other halogenated inhaled anesthetics, Sevoflurane is reported to lessen the severity of decreased hepatic blood flow and undergoes a different mechanism of hepatic metabolism. In patients with preexisting liver disease, there is potential for low-flow Sevoflurane to induce acute liver damage through other mechanisms. Limited data exists to guide clinical decision-making when quantifying the severity of cirrhosis in patients with hepatitis C and its relationship to anesthesia choice. Previous studies have found that exposure to general anesthesia during abdominal surgery may increase the risk of hepatorenal failure. This study has raised a concern that anesthetics may interfere with various hepatic functions secondary to viral infection. The generation of abnormal liver enzymes and hypercoagulation has provided further exploration for such toxicity.

A 53-year-old African American man, with a significant past medical history of controlled hypertension and chronic, uncontrolled Hepatitis C infection, and abdominal trauma in 1983, presented to the community hospital with abdominal discomfort with a 10 x 8 cm ventral hernia. The patient had an underlying hepatitis C infection, but was asymptomatic upon interview. Patient was subsequently scheduled for elective hernia repair for lysis of adhesions, component separation, and mesh placement. General anesthesia, which included low doses of fentanyl, propofol, rocuronium, and ketamine were maintained with sevoflurane, all of which lasted 4 hours. The patient remained hemodynamically stable throughout the procedure. Postoperatively, he showed signs of hemodynamic instability, suggestive of DIC and acute renal failure. Patient expired soon after, and autopsy revealed macronodular cirrhosis with dilated venous collaterals, pulmonary edema, and cardiomyopathy.

This report demonstrates a clinical impact and further evaluation in current patient management. It creates awareness and demonstrates the necessity to evaluate patients with any severe disease and its contraindications to proposed treatment plans. Knowledge of anesthetic induced toxicities and comorbidities has been illustrated, as in the case with sevoflurane and chronic Hepatitis C. Although more studies are needed, physicians should determine the risks and benefits in such patients into operative procedures, as well as management strategies to prevent any possible mortality.

To read the full article Peer-reviewed Article PDF image | Peer-reviewed Full Article image

Author(s): Nickul Shah Nina Ballone Raul Zamora Peter DeVito and Samuel Wilson


Chronic hepatitis C, Cirrhosis, Sevoflurane, Disseminated intravascular coagulation, Elective hernia repair, Hepatitis C, Clinical and Diagnosis, Clinical Laboratory Research

Peer Reviewed Journals
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version