الفهرس يوجد فقط 14 صفحة متاحة للعرض العام
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المستخلص
Cirrhosis is the most advanced stage of most types of chronic liver disease. Major functions of the liver include metabolism, detoxification and excretion of endogenous compounds, drugs, and toxins as well as synthesis of plasma proteins, glucose, and blood coagulation factors Because of its reserve and regenerative ability, the liver can sustain considerable damage before hepatic dysfunction becomes clinically manifest, and therein lies the challenge to preoperative assessment Most inhalational anesthetic agents reduce hepatic blood flow and can impair the liver’s response to these insults. When these events occur during anesthesia and surgery, hepatocyte damage and liver failure can result Isoflurane is a halogenated methyl ethyl ether that is an isomer of enflurane.. Isoflurane, like enflurane, requires no preservative, does not react with metal, and is stable in soda lime and ultraviolet light. The low blood/gas partition coefficient of isoflurane allows rapid induction and recovery. However, the rate of induction may be limited by the mildly pungent ethereal odor of isoflurane Only 0.17% of isoflurane taken up in man appears as urinary metabolites. This resistance to biodegradation may explain the minimal or absent hepatotoxicity and nephrotoxicity of isoflurane. Because its biotransformation to inorganic fluoride is slight, isoflurane does not cause post anesthetic functional or pathologic renal abnormalities in animals or man Sevoflurane is a colourless, volatile, nonflammable liquid with a characteristic mild odour resembling ether. Chemically, sevoflurane constitutes a polyfluorinated methyl-isopropyl compound.