Effects of Different Anesthesia Methods on Hemodynamics,Cerebral Oxygen Metabolism and Pain-causing Substances in Living Donor Liver Transplantation Patients
LI Chao, ZHU Hong-kuan, CHEN Yong-lun
Department of Anesthesiology,Qujing First People's Hospital,Qujing Yunnan 655000
Abstract:【Objective】 To analyze the effects of different anesthesia methods on hemodynamics,cerebral oxygen metabolism and pain-causing substances in living donor liver transplantation (LDLT) patients.【Methods】 A total of 112 LDLT patients admitted to our hospital were selected in this study.According to the random number table method,patients were divided into the sevoflurane group ( anesthesia with sevoflurane,n=56) and the isoflurane group ( anesthesia with isoflurane,n=56).The changes of hemodynamic indexes [heart rate (HR) and mean arterial pressure (MAP)] and cerebral oxygen extraction rate (CO2ER) and jugular venous blood oxygen saturation (SjvO2) were compared between the two groups before operation,before anhepatic phase,35 min in anhepatic phase,30 min in neohepatic phase,2 h in neohepatic phase,and 12 h in neohepatic phase.Changes of pain-causing substances [substance P (SP) and 5-hydroxytryptamine (5-HT) in serum] at 12 h and 24 h after surgery in the two groups of patients were compared between the two groups as well.The adverse reactions of the two groups of patients in the perioperative period were recorded.【Results】 There were no significant differences in HR,MAP,CO2ER and SjvO2 between the sevoflurane group and the isoflurane group before surgery and 12 h in neohepatic phase (P>0.05).From pre-anhepatic phase to 2 h in neohepatic phase,HR and SjvO2 in the sevoflurane group were lower than those in the isoflurane group (P<0.05),and MAP and CO2ER in the sevoflurane group were higher than those in the isoflurane group (P<0.05).At 24 h after surgery,serum SP and 5-HT levels in both sevoflurane group and isoflurane group were higher than those in both groups at 12 h after surgery (P<0.05).Serum SP and 5-HT levels in the sevoflurane group were lower than those in the isoflurane group at 12 h and 24 h after surgery (P<0.05).There was no significant difference in the incidence of perioperative adverse reactions between two groups (P>0.05).【Conclusion】 Compared to the way of anesthesia with isoflurane,method of anesthesia with sevoflurane has less effect on perioperative hemodynamics and cerebral oxygen metabolism in LDLT patients,and it can significantly inhibit the level of postoperative pain-causing substances,which is safe and worthy of clinical promotion and application.
李超, 朱洪宽, 陈永伦. 不同麻醉方法对活体肝移植患者血流动力学、脑氧代谢和致痛物质的影响[J]. 医学临床研究, 2023, 40(1): 10-13.
LI Chao, ZHU Hong-kuan, CHEN Yong-lun. Effects of Different Anesthesia Methods on Hemodynamics,Cerebral Oxygen Metabolism and Pain-causing Substances in Living Donor Liver Transplantation Patients. JOURNAL OF CLINICAL RESEARCH, 2023, 40(1): 10-13.
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