Overview
Enflurane hepatitis is a rare but severe idiosyncratic reaction characterized by acute liver injury following exposure to the volatile anesthetic enflurane 1.Diagnosis
Clinical presentation includes jaundice, elevated liver enzymes (AST, ALT), and often fever 1.
Liver biopsy may show hepatocellular necrosis 1.
No specific diagnostic tests; diagnosis is primarily clinical and based on temporal association with enflurane exposure 1.Management
Discontinue enflurane and supportive care including monitoring liver function and managing complications 1.
No specific antidote; treatment is largely supportive with management of hepatic failure symptoms 1.
Consider liver transplantation in cases of severe, irreversible liver failure 1.Special Populations
No specific data provided in the abstracts regarding pregnancy, pediatrics, elderly, or comorbidities 12.Key Recommendations
Discontinue enflurane immediately upon suspicion of enflurane hepatitis to prevent further liver damage (Evidence: Expert opinion) 1.
Monitor liver function tests closely and manage complications as they arise (Evidence: Expert opinion) 1.
Consider advanced supportive measures or liver transplantation for patients with severe hepatic failure (Evidence: Expert opinion) 1.References
1 Demarquette A, Perrault T, Alapetite T, Bouizegarene M, Bronnert R, Fouré G et al.. Spin and fragility in randomised controlled trials in the anaesthesia literature: a systematic review. British journal of anaesthesia 2023. link
2 Lin YJ, Wang YC, Huang HH, Huang CH, Liao MX, Lin PL. Target-controlled propofol infusion with or without bispectral index monitoring of sedation during advanced gastrointestinal endoscopy. Journal of gastroenterology and hepatology 2020. link