Premium
The effects of desflurane and propofol‐remifentanil on postoperative hepatic and renal functions after right hepatectomy in liver donors
Author(s) -
Ko Justin Sang,
Gwak Mi Sook,
Choi Soo Joo,
Kim Gaab Soo,
Kim Jie Ae,
Yang Mikyung,
Lee Sangmin Maria,
Cho Hyun Sung,
Chung In Sun,
Kim Myung Hee
Publication year - 2008
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.21490
Subject(s) - medicine , desflurane , propofol , renal function , remifentanil , anesthesia , hepatectomy , liver function , blood urea nitrogen , prothrombin time , liver transplantation , creatinine , bilirubin , albumin , urology , liver function tests , surgery , transplantation , resection
Various volatile anesthetics have been used in hepatectomy in living donors, and their effects on major organs have been extensively evaluated. However, the impact of total intravenous anesthesia (TIVA) on postoperative liver and renal functions after large liver resections has been less extensively investigated than that of volatile agents. The aim of this study was to compare the postoperative hepatic and renal functions between volatile anesthesia with desflurane and TIVA with propofol‐remifentanil in living donors undergoing right hepatectomy. Seventy adult patients were randomly allocated into 2 groups: the desflurane group (n = 35) and TIVA group (n = 35). Aspartate aminotransferase, alanine aminotransferase, prothrombin time (PT), albumin, total bilirubin (TB), blood urea nitrogen (BUN), creatinine (Cr), BUN/Cr ratio, estimated glomerular filtration rate (GFR), platelet count, and hemoglobin levels were analyzed in the preoperative period, immediately after the operation, and on the first, second, third, fifth, seventh, and thirtieth postoperative days (PODs). Most of the liver function test results were not significantly different between the 2 groups. However, PT (international normalized ratio) and TB were significantly greater on POD 5 in the TIVA group. Among the renal function tests, Cr was significantly higher and estimated GFR was significantly lower on POD 1 in the TIVA group. The platelet counts and hemoglobin levels were similar between the 2 groups. In conclusion, the results of our study suggest that living related donors for liver transplant may have a better outcome following anesthesia with desflurane. However, further testing will be necessary to prove this hypothesis. Liver Transpl 14:1150–1158, 2008. © 2008 AASLD.