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British Journal of Anaesthesia, 2002, Vol. 88, No. 2 285-287
© 2002 The Board of Management and Trustees of the British Journal of Anaesthesia

Short Communications

Effect of spinal anaesthesia on plasma concentrations of glutathione S-transferase

D. C. Ray*,1, A. G. Robbins1, A. F. Howie2, G. J. Beckett2 and G. B. Drummond1

Departments of 1Anaesthesia, Critical Care and Pain Medicine and 2Clinical Biochemistry, Royal Infirmary, Lauriston Place, Edinburgh EH3 9YW, UK*Corresponding author

Background. Plasma glutathione S-transferase (GST) concentration measurement is a sensitive and specific index of hepatocellular injury. GST concentration increases after anaesthesia with most volatile anaesthetic agents, but not after propofol. Such increases are thought to result from reduced liver blood flow. The effect on GST concentration of spinal (subarachnoid) anaesthesia, which might also reduce liver blood flow, is not known.

Methods. We studied the effects of spinal anaesthesia on GST concentrations measured by specific radioimmunoassay in 33 patients undergoing intermediate orthopaedic, general or gynaecological surgery. GST concentrations were measured before anaesthesia and 3, 6 and 24 h after induction of anaesthesia. Hypotension (systolic blood pressure <70% of pre-induction value) was rapidly corrected with i.v. ephedrine.

Results. Mean duration of surgery was 41 min (range 11–80). No increase in GST concentration was observed at any time, but at 24 h GST concentration was significantly reduced (P<0.05). One patient in whom hypotension was not treated developed a greatly increased GST concentration at 3 h.

Conclusion. We found no association between spinal anaesthesia and disturbance of hepatocellular integrity when hypotension does not occur or is rapidly corrected.

Br J Anaesth 2002; 88: 285–7


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