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Postoperative morphine concentration in infants with or without biliary atresia and its association with hepatic blood flow
Author(s) -
Wang X.,
Qiao Z. W.,
Zhou Z. J.,
Zhuang P. J.,
Zheng S.
Publication year - 2014
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/anae.12624
Subject(s) - medicine , biliary atresia , perfusion , blood flow , morphine , anesthesia , gastroenterology , atresia , surgery , liver transplantation , transplantation
Summary We measured pre‐operative hepatic blood flow and postoperative morphine concentration in infants with or without biliary atresia. Thirty‐four infants (0–3 months) with biliary atresia undergoing portoenterostomy (Kasai operation) were included and hepatic blood flow was assessed by magnetic resonance imaging before surgery in 12 of them. Sixteen subjects (0–3 months) without liver disease undergoing abdominal or pelvic surgery acted as controls and six of them had hepatic blood flow assessed. Intravenous morphine (8 μg.kg −1 .h −1 ) was administered to all patients postoperatively. The median (IQR [range]) relative hepatic blood flow was 3.51 (2.72–3.88 [1.68–4.43]) with and 3.15 (2.66–4.42 [2.30–5.01]) without biliary atresia (p = 0.851). The median (IQR [range]) morphine concentration after 24 h infusion was 5.9 (4.5–16.4 [2.9–42.2]) ng.ml −1 and 6.4 (3.2–12.0 [1.9–48.6]) ng.ml −1 , respectively (p = 0.460). An inverse regression relation was found between the morphine concentration and the hepatic perfusion index (R 2 = 0.519, p = 0.001). Compensatory increases in hepatic arterial blood flow maintain the total hepatic blood flow in infants with biliary atresia.