This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: JIPMER 2018, Subject name: Anaesthesia
Which anaesthetic agent does not affect blood flow to liver? 
Select and explain. 
A. Halothane, B. Isoflurane, C. Enflurane, D. Sevoflurane
B: Isoflurane
Answer: B: Isoflurane 
Explanation: - Total hepatic blood flow = hepatic aery blood flow + poal blood flow- Liver maintains total hepatic blood flow by autoregulation- All inhalational anesthetic agents disrupt dual blood supply of liver - Halothane completely disrupts dual blood supply- Halothane - acyl halide (metabolite) - Auto immune hepatitis - Enflurane also affects liver blood flow- Isoflurane, sevoflurane & desflurane - maintain hepatic blood flow - Desflurane - Best in maintaining liver blood flow - Not metabolized by liver and kidney - Sevoflurane - Higher MAC- Decreases little amount of hepatic blood flow