Interest of BIS monitoring to guide propofol infusion during the anhepatic phase of orthotopic liver transplantation.

作者信息

Tremelot L, Restoux A, Paugam-Burtz C, Dahmani S, Massias L, Peuch C, Belghiti J, Mantz J

机构信息

Department of Anesthesia and Critical Care Service, Beaujon University Hospital, 100, boulevard du Général-Leclerc, 92100 Clichy, France.

出版信息

Ann Fr Anesth Reanim. 2008 Dec;27(12):975-8. doi: 10.1016/j.annfar.2008.10.005. Epub 2008 Nov 22.

OBJECTIVE

The anhepatic phase of orthotopic liver transplantation (OLT) is associated with significant changes in pharmacokinetics. The aim of this study was to compare the influence of this phase on propofol target concentrations during BIS guided target controlled infusion (TCI).

STUDY DESIGN

Prospective study.

PATIENTS AND METHODS

Eight patients aged 25 to 65 years, Child-Pugh status A-B scheduled for OLT were prospectively included. Anesthesia was performed using TCI of propofol (Diprifusor, Marsh pharmacokinetic model), sufentanil and cisatracurium. Propofol target concentration was adjusted to maintain BIS values between 40 and 50.

RESULTS

To maintain stable BIS values, propofol target concentrations should be decreased during the anhepatic phase versus the dissection one (2.0 microg/ml+/-0.8 versus 3.0 microg/ml+/-0.9, p<0.0001).

CONCLUSION

BIS could be useful to titrate propofol infusion during the anhepatic phase of OLT.