Background: Cases with high levels of liver enzyme may experience a decline in liver function as a result of anesthesia and surgery; consequently, it may be crucial to select anesthetics that exhibit minimal hepatotoxicity.
Objectives: We aimed to compare the effect of INHA and TIVA on the liver function in patients with NASH after LSG.
Patients and methods: The cases were randomly assigned to two equal groups; In Group I (TIVA group), propofol and fentanyl were used to induce and maintain an aesthesia, propofol and fentanyl were used to induce anesthesia in Group II (SEVO group) and sevoflurane was used to maintain it. A comprehensive history, vital signs, and laboratory tests were conducted on all cases.
Results: Regarding the liver function tests, in group I (TIVA group), ALT and AST were insignificantly different between baseline and postoperative day 1 and postoperative day 2 and between POD1 and POD2. In group 2 (SEVO group), both ALT and AST at POD 1 and 2 were higher to baseline values (P<0.05) and were significantly higher at POD 2 compared to POD 1 (P<0.05). When comparing between both groups, TIVA group had lower levels of ALT and AST in comparison to SEVO group at POD 1 and 2 (P<0.05).
Conclusion: We concluded that TIVA was superior and safe compared to SEVO in maintaining the liver enzymes (ALT and AST) postoperatively, unlike SEVO which showed elevation in ALT and AST levels.  Moreover, TIVA showed less postoperative pain and analgesic consumption, with higher satisfaction rate compared to SEVO.