Induction of general anesthesia with ketamine for short surgical interventions in pediatric patients with chronic hepatic pathologies

: Serum levels of bilirubin and of other four enzymes known to be elevated in liver diseases were measured preoperatively and controlled on the first and fourth postoperative day in 14 children with chronic liver disease and anesthetised for liver biopsy using Ketamine (7 patients, group A) or other drugs (group B). Serum levels of gamma GT, Ph. Alk, direct and indirect bilirubin show neither significant variations nor differences between the two groups of patients. SGOT and SGPT basal levels were similar in the two groups and were rather two-fold the normal values. At the first postoperative day, in group B only SGOT levels increased significantly. Moreover, their increase over the basal levels monitored at the first day was significantly lower in the group of patients anesthetised with Ketamine than in group B. In group A, SGPT values were constant showing a small, non significant decrease, while in group B, above levels present a significant increase at the postoperative day and a significant difference between the two groups. At the fourth day, SGOT and SGPT differences versus basal values were not significant. Our experience shows that - as known by normal subjects - Ketamine has no hepatic toxicity in pediatrics patients affected by chronic liver disease, too. Finally, our study suggests that Ketamine must be used in hepatopath children whenever they have to be submitted to total anesthesia.