ANAESTHETIC MANAGEMENT OF PATIENT WITH GILBERT’S SYNDROME
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2015, Vol 4, Issue 55
Abstract
Gilbert’s syndrome is characterized by mild unconjugated hyperbilirubinemia without either structural liver disease or hemolytic anemia. Bilirubin is produced during the breakdown of hemoglobin and hemoproteins. Since bilirubin is insoluble in water, it must be converted into a soluble conjugate form in the liver before elimination from the body. In the liver, enzyme uridine diphosphate (UDP) glucoronosyltransferase converts the bilirubin into the mixture of monoglucoronides and diglucoronides referred as conjugated bilirubin. The relative deficiency of UDP glucoronosyltransferase results in reduced activity nearly 10-30% normal, leading to unconjugated hyperbilirubinemia, Gilbert’s Syndrome (GS). Since majority of anesthetic agents require this enzyme for their metabolism and excretion, its deficiency leads to potential accumulation of such drugs resulting in anesthetic toxicity with adverse outcome. Anesthetic management of Patient with Gilbert’s Syndrome is quite challenging. A thorough knowledge of pathophysiology and precipitating factors of GS are essential for safe administration of anesthesia.
Authors and Affiliations
Vishwanath Hiremath
Keywords
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- EP ID EP117491
- DOI 10.14260/jemds/2015/1399
- Views 90
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