Comparison of perioperative myocardial injury caused by live donor liver transplantation performed under sevoflurane and propofol combined anesthesia in adult patients / 中华麻醉学杂志

ABSTRACT

Objective To compare the severity of periopemtive myocardial injury caused by live donorliver transplantation (LDLT) performed under sevoflurane and pmpofol combined anesthesia in adult patients. Methods Forty ASA Ⅱ-Ⅳ patients(liver function Child-Pugh grade B or C)aged 40-67 yr weighing 47-95 kgundergoing right lobe LDLT were randomly divided into 2 groups(n=20 each)sevoflurane combined anesthesiagroup (group S) and propofol combined anesthesia group(group P).Anesthesia was maintained with 1.6%-3.0% sevoflurane in group S or PCI of pmpofol(Cp 2-4μg/ml)in group P combined with sufentanil infusion at 0.5- 1.0 μg·kg-1·h-1 and intermittent iv boluses of cisatracurium in both groups.MAP,HR,CVP,MPAP,PCWP, CO and mixed venous O2 saturation(S(v)O2)were recorded before skin incision at 5 and 30 min of anhepatic phaseand 5 and 30 min of ncohepatic phase and the end of operationBlood samples were taken from central vein beforeskin incision(T0,baseline)at 30 min of anhepatic phase(T1),30 min of neohepatic phase(T2),the end ofsurgery (T3) and 24,48,72 h after operation (T4,5,6) for determination of serum concentrations of cardiactroponin I (cTnI) and creatine kinase MB(CK-MB).Postoperative adverse effects were recorded.Results Thetwo groups were comparable with respect to 8ex ratio(M/F),age,body weight,duration of operation,duration ofanhepatic phase,blood loss,dopamine and nitroglycerin consumption.There was no significant difference in MAP, HR,CVP,MPAP,PCWP,CO and S(v)O2 between the two groups.The serum concentrations of cTnI and CK-MB were significantly increased at T2-5 as compared with the baseline value at T0 in both groups. There was no significant difference in serum concentrations of cTnI and CK-MB and in the incidence of myocardial ischemia and arrythmia between the two groups. Conclusion Sevoflurane and propofol combined anesthesia have similar effects on myocardial injury caused by LDLT in adult patients.