General anesthesia in a patient with Gilbert’s syndrome.

Having had an operation this year, with a very understanding anesthesiologist, I know that this is an area of poor knowledge in the health service, and that all the advice you as a patient can offer is helpful, and will of course help yourself. We decided that morphine would be avoided and took an approach that would mean using as few drugs as possible. This also meant I would come out of the procedure more alert and able to get going.

There has been some recent research in India which follows the clinical experience I have personally had – namely that the best outcomes are if the drugs used avoid using the enzyme that people with Gilbert’s Syndrome are deficient in:


Department of Anaesthesiology and Critical Care, Tata Main Hospital (TMH), Jamshedpur, India. Nag DS, Sinha N, Samaddar DP, Mahanty PR.


Gilbert’s syndrome, caused by relative deficiency of glucuronyl transferase is the commonest cause of congenital hyperbilirubinemia. We report anesthetic management in a case of Gilbert’s syndrome for laparoscopic cholecystectomy under general anesthesia. Avoiding drugs which use this enzyme for its metabolisim or excretion, and minimizing the stress during the perioperative period allows safe conduct of anesthesia for these patients.

4 Replies to “General anesthesia in a patient with Gilbert’s syndrome.”

  1. Im 37 yrs old diagnosed with Gilbert syndrome since birth
    And high billurubin and direct billurubin ang I test GGT test I was disappointed about the results I also undergo abdomen ultrasound it’s normal my question is what should I do if I have high billurubin and direct billurubin it’s affect to my job application thank you

    1. Hi there, the tests and symptoms you describe are the standard to get to a diagnosis of Gilbert’s Syndrome and will be familiar to many people. You also ask the most common question – so what do I do to help myself?! Sadly doctors don’t usually help with this advice once you have a diagnosis. This is why we’re here. I’ve added a number of posts, on diet, sleep, resources etc which should help. I’ve also produced a course ‘Gilbert’s Syndrome Essentials’ which will soon be available to the wider public. Meanwhile, posts such as this should help, and keep reading the site, subscribe, join us over on twitter and instagram. I hope some of these things help. If you want personalised support then a health and nutrition coach can help (I’ve trained as a coach and believe that this support can really help you find your own solutions, when added to the medical support you receive from your healthcare providers). Email for more information. Wishing you well

  2. I’m 70 years old & just discovered I have GS from a gene study. I’ve suffered from many of the symptoms most my life, without jaundice. I have had general anesthesia on several occasions in the past. Each time I have had difficulty waking up and been rather ill after. I have opted for local anisthesia whenever possible. Recently I had breast cancer surgery. It was difficult convincing the Doctor & anisthesologist to not administer the general. I was surprised how wonderful I felt directly after surgery. Now I understand why.
    Thanks for the info.
    Understanding GS is helping me with many of my health issues which have baffled both me and my doctors.

  3. I had a hysterectomy several years ago before I was aware that I had Gilbert’s Syndrome. I did not regain consciousness until 12 hours later and was monitored very closely as my respiration steadily decreased. I don’t understand what really happened as I wasn’t told but this article has made it clear to me that it was due to the syndrome that I had a bad reaction to the anesthetic

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