The liver s a vital reservoir of blood in humans. Several laboratory tests, flinging tools are available or the diagnosis of liver disease and liver biopsy certain anesthetics can induce serious alterations in postoperative hepatic function. The goal of preoperative management of patients with elevated liver enzymes is prevention of acute liver failure or further hepatic deterioration. Local anesthesia with sedation is usually the least invasive for relatively minor procedures. Isoflurane and probably sevoflurane appear to be anesthetics of choice for inhalational anesthesia. Fentanl is probably the opioid of choice.