Abstract
Objective To compare the severity of periopemtive myocardial injury caused by live donor liver 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 kg undergoing right lobe LDLT were randomly divided into 2 groups(n=20 each):sevoflurane combined anesthesia group (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 phase and 5 and 30 min of ncohepatic phase and the end of operation:Blood samples were taken from central vein before skin incision(T0,baseline)at 30 min of anhepatic phase(T1),30 min of neohepatic phase(T2),the end of surgery (T3) and 24,48,72 h after operation (T4,5,6) for determination of serum concentrations of cardiac troponin I (cTnI) and creatine kinase MB(CK-MB).Postoperative adverse effects were recorded.Results The two groups were comparable with respect to 8ex ratio(M/F),age,body weight,duration of operation,duration of anhepatic 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. Key words: Anesthetics, inhalation; Propofol; Liver transplantation; Myocardial reperfusion injury
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