Structural and ultrastructural studies on normal and bilharzial human liver following isoflurane and sevoflurane anaesthesia

ABSTRACT

Liver specimens from 30 adult female patients with normal liver function tests were examined. Half of the patients were normal and the other half had history of bilharziasis. All patients had chronic calcular cholecystitis and scheduled to undergo open cholecystectomy. After induction of anesthesia with fentanyl, propofol and vecuronium, anesthesia was maintained with 65% nitrous oxide in oxygen supplemented by propofol infusion as total intravenous anesthesia to the control group or by one minimum alveolar concentration [MAC] to patients of either isoflurane or sevoflurane groups. Approximately, 60 minutes after starting the maintenance anesthetic agents, a liver biopsy was taken from each patient and processed for light and electron microscopy. Similar structural and ultrastructural changes were detected in both normal and bilharzial liver specimens after the use of isoflurane and sevoflurane anesthetics. Those changes only differed in magnitude. They were in the form of focal sinusoidal dilatation, cellular swelling, nuclear and mitochondria1 degeneration, fragmentation of rough endoplasmic reticulum [rER], increased lysosomes, cytoplasmic vacuolation which may be partially or completely surrounded by membrane and may contain electron dense granular structures