الفهرس 
Comparative study of the change in liver enzymes after general or spinal anesthetic techniques in patients with preoperatively elevated liver enzymes
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Abstract
Purpose: The Aim of this study was to compare the change in liver enzymes in patients with elevated liver enzymes preoperatively after general or spinal anesthetic techniques. Methods: A total of 60 patients with stationary raised liver enzymes were enrolled in this randomized prospective comparative study and were allocated randomly into two groups scheduled for lower limb or extraperitoneal lower abdominal surgery: group A (n=30) where general anesthesia was used, group B (n=30) where spinal anesthesia was used. The liver function tests (AST, ALT, Total and direct Bilirubin) were measured preoperatively and after 24 and 48 hours postoperatively. Intraoperative monitoring of vital signs, vasopressor use and fluid replacement were recorded. Results: There were no significant differences between the two groups regarding the age, gender, medical history, duration or type of surgery performed and intraoperative adverse events. As for intraoperative vital signs, no difference between the two groups regarding the heart rate. group (B) experienced significantly lower blood pressure during the surgery compared to group (A) (P<0.05). All the liver enzymes were elevated significantly in both study groups postoperatively (Repeated measures ANOVA, P<0.05). However, No significant difference was found between the two groups at each measurement point (Independent samples t test, P>0.05). Conclusions: General anesthesia and Spinal anesthesia both cause mild elevation of Liver function tests in asymptomatic patients with elevated liver enzymes preoperatively. Careful monitoring and choosing appropriate anesthetic regimen and drugs are essential to minimize the effect of anesthetics on liver function tests and the liver condition in such patients