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Abstract PREFACE The liver is unquestionably the largest and most complex organ. The multitudinous functions impinge on anaesthesia in a very direct fashion frora biotransfor-mation of drugs to synthesis of coagulation factors. Actually, most of the effects of anaesthetics on the normal liver, like those on the brain, are ephemeral and dissipate just as surely as the patients awaken . Mentioning the liver to an anaesthetist, two scenes are brought to mind. The first is the spector of post-anaesthesia hepatic necrosis, the so-called ”halothane hepatitis” syndrome. The second picture is the emergency oesophageal varix procedure, with a moribund, jaundiced patient haemorrhaging frorc every orifice. Both these situations stand at the extreme poles of hepatic problems encountered in daily practice. Among these hepatic problems is the problem of anaesthetising a patient with bilharzial liver fibrosis undergoing surgery. This is because indirect evidence suggests that anaesthesia and surgery do in fact accentuate pre-existing liver disease. It is unfortunate that it is not possible at present to monitor most of the important biochemical events of the liver on a rainute-to-minute basis. This sophi |