Postoperative Liver Function after Hepatic Resection with Hepatic Ischemic Insult under Enflurane Anesthesia. |
Bong Il Kim, Chan Hong Park, Won Jae Kang |
Department of Anesthesiology, School of Medicine, Catholic University of Taegu-Hyosung, Taegu, Korea. |
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Abstract |
BACKGROUND The most common cause of postoperative hepatic dysfunction is decreased hepatic blood flow due to decreased cardiac output and vasoactive substance during anesthesia.
It might be suggested that hepatic blood flow occlusion affects postoperative dysfunction. This study was designed to investigate this possible effect on postoperative liver function. METHODS Forty-seven patients; hepatic resection with temporarily hepatic vascular occlusion (Pringle's maneuver) under enflurane anesthesia were involved. The duration of liver ischemia was 44.2 20.0 min. Blood transfusions (8.3 5.1 pints) were administered to nine patients intraoperatively. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), and total bilirubin (TB) were measured at preoperation, postoperative 6 hours, 1, 3, 7 and 14 days. Alkaline phosphatase (AP) was measured also but not at postoperative 6 hrs. RESULTS The values of postoperative AST, ALT, LDH were increased sharply but returned at postoperative 7th day. AP did not change significantly. TB levels rose for 7 days postoperatively and then fell. CONCLUSION From these results, it is inferred that the effect of hepatic ischemic insult under enflurane anesthesia on postoperative liver function is not significant. |
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