Comparing the Effect of Propofol and Sevoflurane on Hemodynamics and Coagulation Status During Liver Transplant Anesthesia and Hepatic and Renal Function of the Patients after Liver Transplant

Abstract

Background: At present, no documented anesthetic technique exists for use in liver transplant surgery. Presence of some controversies in anesthesia plan led us to compare effects of inhaled and intravenous anesthetics in liver transplant surgery.

Methods: All those brain dead patients who met the criteria of organ donation were included in the study. The donor's liver is matched with the recipient according to our liver transplant protocols and assigned consecutively to the recipients. In this study 78 patients who met the inclusion criteria, were divided into two groups.

All patients in group 1 were anesthetized with inhalation of sevoflurane and patients in group 2 were anesthetized with the IV injection of propofol. Percent of sevoflurane in inhaled gases and IV infusion dose of propofol was determined by a BIS guide to keep BIS between 40 and 45. Patients were monitored by NIBP, ECG, CO – Oximetry and BIS before and during induction of anesthesia. An arterial line from radial artery and Swan–Ganz–Catheter from right internal jugular vein were inserted for all patients.

Results: Mean of PCO2, PO2 and HCO3 were different between 2 groups (p=<0.05) and were higher in propofol group. Also, mean of Na and K were different in both groups and were higher in sevoflurane group, and no other significant differences found.

Conclusion: The results showed that the effect of propofol and sevoflurane on hemodynamics, coagulation status during liver transplant anesthesia, and hepatic and renal function of the patients after liver transplant is the same.