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Dr J Burk
Dr J Burk, Doctor (MD)
Category: Health
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Experience:  MBBS MRCGP
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This is a question for an anesthesiologist, or someone with

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This is a question for an anesthesiologist, or someone with detailed knowledge of all chemicals used in anesthesiology.
My fiancee, age 38, is in Tacloban, Leyte, Philippines. She had schistosomiasis, probably for over 3 years, before it was cured. That resulted in liver cirrhosis. She drinks NO alcohol. She eats a lean, well-balanced diet, and her condition seems to be stable. Her AST/ALT are in the normal range, although, at times, they have been near the high end of the normal range.
Because she has practically ZERO breast tissue, we considered a breast implant operation for her. However, her personal physician and a cardiologist have stated that would be dangerous for her, and a well-respected plastic surgeon said, in effect, "Let's see what her AST/ALT are, when the time comes." Apparently, the primary concern is the effect of the anesthetic on her liver. Our children and I want her, alive, and I do not want her to do anything that would make her liver worse. Unless you know of a way that it can be done safely, the implant operation will not happen.
This, however, has raised another question: what will happen, if she ever NEEDS a surgery that is NOT elective? Are there any anesthetics that do not seriously stress the liver? If so, which ones are they? Are they truly safe for someone with cirrhosis, or are they "the best of the bad options?" Your advice is very much appreciated.
Very truly,XXXXX

Hi

 

None of the modern anesthetic agents affect the liver.

 

Halothane - an old inhalational agent was infamous for causing liver damage ( halothane hepatitis)

 

As a former anesthesiologist I would have no major concerns - so long as her bloods were OK pre-op.

 

Dr Jef

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