[Mobilization of alpha-glutathione S-transferase in the anesthetized patient]. / Movilización de la enzima alfa glutatión S-transferasa en el paciente anestesiado.

OBJECTIVE: To measure and assess changes in plasma concentrations of alpha glutathione S-transferase (alpha-GST) during and after anesthesia with isoflurane, desflurane and propofol. PATIENTS AND METHODS: Study of 90 ASA I and II patients scheduled for lumbar back surgery under general anesthesia assigned randomly to one of three groups to receive anesthetic maintenance with isoflurane, desflurane or propofol. We measured plasma levels of alpha-GST, aspartate aminotransferase aspartate, alanine aminotransferase, alkaline phosphatase, pseudocholinesterase, gamma glutamyltransferase and total bilirubin at baseline and several times during and after surgery. RESULTS: Changes in plasma levels of alpha-GST were detected in all three groups, the tendency to increase reaching its peak with the sample taken at the end of anesthesia. The ranges considered normal were not exceeded in any of the patients studied. CONCLUSIONS: By measuring alpha-GST changes in plasma, we have detected signs of disturbance in hepatocellular integrity after anesthesia with all three maintenance agents used. However, the slight and transitory nature of the events confirms the scarce hepatotoxic potential of isoflurane, desflurane and propofol.