Comparison of bispectral index targeted end-tidal concentration of desflurane during three phases of orthotopic liver transplantation

Autor: Gyanendra Kumar, Nitin Sethi, Deepanjali Pant, Jayashree Sood, Amarjeet Singh, Shashank Pandey, Amitabh Dutta
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: Indian Journal of Anaesthesia, Vol 63, Iss 3, Pp 225-230 (2019)
Druh dokumentu: article
ISSN: 0019-5049
0976-2817
DOI: 10.4103/ija.IJA_693_18
Popis: Background and Aims: Reduced inhalational anaesthetic requirement in end-stage liver disease during living donor orthotopic liver transplantation (LD-OLT) is due to increased endogenous opioids. This study evaluated the changes in bi-spectral index (BIS) monitored end-tidal desflurane (ETDes) requirements during ‘dissection’, ‘anhepatic’, and ‘neohepatic’ phases of LD-OLT. Methods: This prospective, cohort study included 40 adults undergoing LD-OLT under general anaesthesia (GA). All patients received BIS-guided desflurane GA. ETDesrequirements in three phases of LD-OLT (primary objective); relationship between inhalational anaesthetic requirements and severity of liver disease; and effect of changes in mean arterial pressure (MAP) and body temperature on ETDesconcentration for all three phases were also evaluated. Results: ETDesduring the ‘dissection’ phase (2.92 ± 0.65%) was > ‘anhepatic’ (2.68 ± 0.85%, P= 0.049) and ‘neohepatic’ phases (2.58 ± 0.71%, P= 0.005). Patients with model of end-stage liver disease (MELD) score < 20 returned significantly greater ETDesthan those with MELD score ≥20 during the ‘dissection’ (MELD
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