ABSTRACT
A new volatile anesthetic, sevoflurane, is widely used in Japan. We first report a patient who developed liver dysfunction following sevoflurane anesthesia. He had a resection of the bilateral extra toes at the age of eleven months. Although no problems occurred during the operation, he had serious liver dysfunction. Fourteen days after operation, serum GOT was elevated to the maximum of 836U. The pathogenesis is considered to be related to sevoflurane anesthesia, because viral hepatitis was excluded, and sevoflurane is considerably positive in lymphocyte stimulation test in contrast with antibiotics.
Subject(s)
Anesthesia, Inhalation , Chemical and Drug Induced Liver Injury/etiology , Ethers/adverse effects , Methyl Ethers , Surgical Procedures, Operative , Humans , Infant , Liver/drug effects , SevofluraneABSTRACT
The effect of adenosine triphosphate (ATP) on systemic and renal hemodynamics was studied in seven dogs anesthetized with pentobarbital and enflurane. Adenosine triphosphate was given via the vena cava, the left atrium, and the abdominal aorta close to the left renal artery. Bolus injection of ATP in the vena cava showed a dose-dependent decrease of mean arterial pressure and renal blood flow, while cardiac output showed only a slight change. Continuous infusion of ATP in the vena cava or the left atrium showed stable hypotension, decrease of renal blood flow, with slight change of cardiac output. Despite the decrease of total peripheral resistance (TRP), renal vascular resistance (RVR) increased significantly in all cases. However, the continuous infusion of ATP into the abdominal aorta close to the left renal artery caused variable responses of systemic arterial pressure and a significant decrease of the RVR. These results suggest that ATP has a renal vasodilator effect only when given directly into the renal artery, and that a renal vasoconstriction occurs responding to the systemic effect of ATP when ATP is given intravenously or into the left atrium.
