Preconditioning Effect of Remifentanil Versus Fentanyl in Prevalence of Early Graft Dysfunction in Patients After Liver Transplant: A Randomized Clinical Trial
| Autor: | Mohammad Ali Sahmeddini, Sanaz Jowkar, Mohammad Bagher Khosravi, Mohammad Hossein Eghbal, Kazem Samadi |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Time Factors Adolescent Remifentanil Primary Graft Dysfunction Iran 030230 surgery Thrombin time Fentanyl law.invention Young Adult 03 medical and health sciences 0302 clinical medicine Double-Blind Method Risk Factors Interquartile range law Humans Medicine Infusions Intravenous Prothrombin time Transplantation medicine.diagnostic_test business.industry Metabolic acidosis Length of Stay Middle Aged medicine.disease Intensive care unit Liver Transplantation Analgesics Opioid Treatment Outcome Anesthesia Female 030211 gastroenterology & hepatology business Anesthetics Intravenous medicine.drug |
| Zdroj: | Experimental and Clinical Transplantation. 18:598-604 |
| ISSN: | 2146-8427 1304-0855 |
| DOI: | 10.6002/ect.2019.0014 |
| Popis: | OBJECTIVES One of the most prevalent complications of orthotopic liver transplant is primary graft dysfunction. Recent studies have shown the preconditioning effect of remifentanil on animal livers but not human livers. Here, we compared the preconditioning effects of remifentanil and fentanyl in orthotopic liver transplant in human patients. MATERIALS AND METHODS In this double-blind clinical trial, 100 patients who underwent liver transplant from deceased donors were randomly allocated into 2 groups. Patients in the remifentanil group received remifentanil infusion, and those in the fentanyl group received fentanyl infusion during maintenance of anesthesia. Serum aminotransferase levels, prothrombin time (international normalized ratio), partial thrombin time, arterial blood gas levels, and renal function tests were evaluated over 7 days posttransplant. Intensive care unit stay and hospitalization were also recorded. RESULTS The median peak alanine aminotransferase level during 7 days after transplant was 2100 U/L (interquartile range, 1230-3220) in the remifentanil group and 3815 U/L (interquartile range, 2385-5675) in the fentanyl group (P = .048). Metabolic acidosis, renal state, prothrombin time (international normalized ratio), and partial thrombin time were similar in both groups (P > .05). Durations of stay in the intensive care unit and hospital were not significantly different between the 2 groups (P = .75 and P = .23, respectively). Overall, the clinical outcomes were similar in the remifentanil and fentanyl groups (P > .05). CONCLUSIONS We found that remifentanil and fentanyl were not different with regard to their preconditioning effects and graft protection in orthotopic liver transplant recipients. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|