Reproducible hepatic dysfunction following separate anesthesia with sevoflurane and desflurane.

Desflurane and sevoflurane have each individually been reported to induce hepatic dysfunction, but not together. As desflurane is oxidatively metabolized by liver cytochrome P-450 to form trifluoroacetylated (TFA) proteins, the primary organic metabolite of sevoflurane is hexafluoroisopropanol (HFIP), and because it seldom forms liver protein adducts, we considered that TFA-protein sensitization was unlikely to induce hepatic dysfunction. We hereby report on a patient who had impaired liver function after both sevoflurane and desflurane were administered on separate occasions. CASE REPORT