Gordon P C, James M F, Lopez J T, Robson S C, Kahn D
University of Cape Town.
S Afr Med J. 1992 Aug;82(2):82-5.
In October 1988 the orthotopic liver transplantation programme recommenced at Groote Schuur Hospital. The experience gained from our first 10 patients is described here. Anaesthesia for this type of surgery is demanding given the long duration of the operation and the severe haemodynamic and physiological alterations that can occur. A rapid sequence induction is usually performed and anaesthesia maintained with fentanyl and isoflurane. Dopamine and mannitol are used for renal protection. Extensive monitoring of haemodynamics, biochemistry, coagulation and temperature is essential. A rapid infusion device is mandatory as massive blood loss may occur. All patients were electively ventilated in the surgical intensive care unit postoperatively. One patient died 11 days postoperatively. The remainder are well at the time of writing.
1988年10月，格罗特·舒尔医院重新启动了原位肝移植项目。本文描述了我们从最初的10例患者身上获得的经验。鉴于此类手术时间长，且可能出现严重的血流动力学和生理改变，因此对这种手术的麻醉要求很高。通常采用快速顺序诱导，并使用芬太尼和异氟烷维持麻醉。多巴胺和甘露醇用于肾脏保护。对血流动力学、生物化学、凝血和体温进行广泛监测至关重要。由于可能发生大量失血，必须配备快速输液装置。所有患者术后均在外科重症监护病房接受选择性通气。1例患者术后11天死亡。在撰写本文时，其余患者情况良好。
