Ozgul U, Ucar M, Erdogan M A, Aydogan M S, Toprak H I, Colak C, Durmus M, Ersoy M O
Department of Anesthesiology and Reanimation, Faculty of Medicine, Inonu University, Malatya, Turkey.
Transplant Proc. 2013 Apr;45(3):966-70. doi: 10.1016/j.transproceed.2013.02.056.
We compared postoperative hepatic and renal functions and coagulation profiles in living donors undergoing right hepatectomy under isoflurane (n = 40) versus propofol (n = 40) anesthesia. After induction, anesthesia was maintained with isoflurane/air-O2 (group I) or propofol/air-O2 (group P) in addition to remifentanil and atracurium infusion in both groups. Aspartate aminotransferase, alanine aminotransferase, international normalized ratio (INR), activated partial thromboplastin time (aPTT), albumin, total bilirubin, blood urea nitrogen, creatinine, estimated glomerular filtration rate (GFR), platelet count, and hemoglobin levels were measured in the preoperative period, after end of the operation, and on the first, third, fifth and seventh postoperative days (PODs). INR was significantly increased on POD 3 and aPTT on POD 5 in group I compared with group P (P < .05). Albumin level was significantly lower in Group I on POD 1 and 3 (P < .05). GFR was significantly lower on POD 1 in the group I compared with group P (P < .05). The postoperative coagulation, GFR, and albumin values were superior following administration of propofol than isoflurane in donors who underwent living hepatectomy; however, both approaches were clinically safe, with no significant clinical difference.
我们比较了在异氟烷（n = 40）与丙泊酚（n = 40）麻醉下接受右半肝切除术的活体供者术后的肝功能、肾功能及凝血指标。诱导后，两组均在输注瑞芬太尼和阿曲库铵的基础上，分别用异氟烷/空气 - 氧气（I组）或丙泊酚/空气 - 氧气（P组）维持麻醉。在术前、手术结束后以及术后第1、3、5和7天（POD）测量天冬氨酸转氨酶、丙氨酸转氨酶、国际标准化比值（INR）、活化部分凝血活酶时间（aPTT）、白蛋白、总胆红素、血尿素氮、肌酐、估计肾小球滤过率（GFR）、血小板计数和血红蛋白水平。与P组相比，I组术后第3天INR显著升高，术后第5天aPTT显著升高（P < 0.05）。I组术后第1天和第3天白蛋白水平显著低于P组（P < 0.05）。与P组相比，I组术后第1天GFR显著降低（P < 0.05）。在接受活体肝切除术的供者中，丙泊酚麻醉后的术后凝血、GFR和白蛋白值优于异氟烷麻醉；然而，两种方法在临床上都是安全的，无显著临床差异。
