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Anesthesia

Liver damage and anesthesia

04/24/2007

Question:

My sister had a brain biopsy to rule out a tumor, she has hept c (from a blood transfusion in 1960) and is on the liver transplant list. It is 5 days and she has not regained consciousness yet. I know her liver is not filter out the anesthesia properly. How long should we expect her out? It has now been 4 days.

Answer:

I'm afraid it's impossible for me to say how long it will take for your sister to recover.

Anyone who is on the liver transplant list is really sick. The anesthesia may have contributed to her failure to regain consciousness but as you know it's not the only factor. Persons with liver failure that is untreated will eventually become comatose as part of what is known as hepatic encephalopathy. The liver processes many substances in the bloodstream that, unprocessed, depress the function of the brain.

What was the result of the brain biopsy? That might shed some light on the cause of your sister's coma. Is there an infection of some sort - bacterial or viral meningitis or encephalitis? Electrolyte disorders, like a low sodium level, or low glucose, can also affect brain function and are common in patients with poor liver function. Drugs beside anesthetic agents can affect the brain too, including sedatives, antibiotics. There are also causes like strokes, or seizures which the doctors may be considering in view of the delayed recovery.

The best thing to do is to consult with your sister's doctors. Tell them your concerns and ask for a few minutes with them to discuss what they think is going on, and what their plans are for diagnosis and treatment. I hope she recovers soon.

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Response by:

Gareth S Kantor, MD Gareth S Kantor, MD
Assistant Professor of Anesthesiology
School of Medicine
Case Western Reserve University