72584
document
DESFLURANE COMPARED TO SEVOFLURANE FOR CIRRHOTIC PATIENTS UNDERGOING MAJOR LIVER RESECTION . A RANDOMIZED CONTROL STUDY . BACKGROUND Major liver resection is associated with haemodynamic , hepatic and renal changes as a result of the procedure . AIM To compare Desflurane ( D ) versus Sevoflurane ( S ) on hepatic , renal functions , haemodynamics and perioperative course for cirrhotic patients undergoing major liver resection . PATIENTS AND METHODS A prospective randomized control study with 50 patients ( Child A ) ( D , n = 25 and S , n = 25 ) . End tidal D or S adjusted with Entropy ( 40-60 ) . Haemodynamics monitored with invasive blood pressure and trans-oesophageal Doppler ( TED ) . Liver and kidney function tests , blood Glutathione-S-transferase ( GST ) , urinary microalbuminuria ( Microalb ) were assayed . Extubation time and anaesthetic consumption were recorded . RESULTS Systemic vascular resistance ( SVR ) post-resection and stroke volume of D vs S were 835.04 ± 12.02 vs 778.16 ± 11.97 dyn.sec.cm ( -5 ) , P < 0.01 , and 85.72 ± 2.95 vs 76.16 ± 6.52 ml , P < 0.01 respectively . Doppler corrected flow time ( FTc ) between groups were comparable ( P > 0.05 ) . No difference post-operatively regarding hepatic and renal functions , and urine Microalb ( 14.76 ± 3.95 vs l4.24 ± 8.65 µg/ml , P = 0.78 ) , but a statistically difference was found with GST ( 0.046 ± [ symbols : see text ] , vs 0.043 ± [ symbols : see text ] IU/ml , P < 0.01 ) . Despite a higher D consumption ( 73 ± 17 vs 64 ± 22 ml , P = 0.102 ) , cost in Egyptian pounds ( LE ) was lower with D ( 141.14 ± 32.90 vs 320.60 ± 114.01 , LE , P < 0.01 ) . Extubation time and ICU stay with D vS ( 4.52 ± 2 vs 7.72 ± 2 min , P < 0.01 ) and ( 1.40 0.50 vs 1.64 ± 0.48 , days P = 0.09 ) respectively . CONCLUSION Neither D nor S were clinically superior to the other with respect to liver and kidneys functions , but D was found to preserve better the haemodynamic parameters and enhance recovery at a lower cost .
72585
Intervention_Pharmacological
Desflurane ( D ) versus Sevoflurane ( S )
72586
Outcome_Physical
hepatic , renal functions , haemodynamics and perioperative course
72587
Outcome_Physical
End tidal D or S adjusted with Entropy
72588
Outcome_Physical
Haemodynamics monitored with invasive blood pressure and trans-oesophageal Doppler ( TED ) . Liver and kidney function tests , blood Glutathione-S-transferase ( GST ) , urinary microalbuminuria ( Microalb ) were assayed .
72589
Outcome_Other
Extubation time
72590
Outcome_Other
anaesthetic consumption were recorded
72591
Outcome_Physical
Systemic vascular resistance ( SVR ) post-resection and stroke volume
72592
Participant_Condition
CIRRHOTIC PATIENTS UNDERGOING MAJOR LIVER RESECTION .
72593
Participant_Condition
cirrhotic patients undergoing major liver resection
72594
Participant_Sample-size
50 patients
72595
Participant_Age
Child A