Question
A patient with mitral stenosis is posted for surgery tomorrow. There is some liver compromise. Which of the following inhalational agent is preferred ?
| A. |
Halothane
|
| B. |
Enflurane
|
| C. |
Xenon
|
| D. |
Sevoflurane
|
Show Answer
|
Correct Answer » C
Explanation
|
|
Xenon is considered the ideal inhalational anesthetic because:
- It undergoes no metabolism.
- It is eliminated unchanged through the lungs.
- It has minimal cardiovascular effects, making it suitable for patients with valvular heart disease.
- It preserves hepatic blood flow and has no hepatotoxicity.
- Therefore, it is the preferred inhalational agent in a patient with both mitral stenosis and liver compromise.
Why Other Options are Incorrect
A. Halothane
- Undergoes approximately 20% hepatic metabolism.
- Associated with halothane hepatitis.
- Reduces hepatic blood flow.
- Not preferred in patients with liver disease.
B. Enflurane
- Undergoes limited hepatic metabolism (2–5%).
- Produces fluoride ions.
- Less favorable than xenon because of greater metabolism and cardiovascular effects.
D. Sevoflurane
- Undergoes approximately 2–5% hepatic metabolism.
- Generally safe in liver disease and commonly used in clinical practice.
- However, compared with xenon, it is not ideal because it is metabolized to some extent.
