A clinical prospective comparison of anesthetics sensitivity and hemodynamic effect among patients with or without obstructive jaundice

Background: To compare isoflurane anesthesia in patients with or without hyperbilirubinemia undergoing hepatobiliary surgery. Methods: Forty‐two patients with obstructive jaundice and 40 control patients with normal liver function scheduled for hepatobiliary surgery under isoflurane anesthesia were...

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Published in:Acta anaesthesiologica Scandinavica 2010-08, Vol.54 (7), p.871-877
Main Authors: YANG, L.-Q., SONG, J.-C., IRWIN, M. G., SONG, J.-G., SUN, Y.-M., YU, W.-F.
Format: Article
Language:English
Subjects:
Adult
Anesthesia
Anesthesia Recovery Period
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Anesthetics - administration & dosage
Anesthetics - adverse effects
Biological and medical sciences
Blood Pressure - drug effects
Consciousness Monitors
Endpoint Determination
Female
Fluid Therapy
Heart Rate - drug effects
Hemodynamics - drug effects
Humans
Isoflurane - administration & dosage
Isoflurane - adverse effects
Jaundice, Obstructive - complications
Jaundice, Obstructive - physiopathology
Male
Medical sciences
Middle Aged
Prospective Studies
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Summary:Background: To compare isoflurane anesthesia in patients with or without hyperbilirubinemia undergoing hepatobiliary surgery. Methods: Forty‐two patients with obstructive jaundice and 40 control patients with normal liver function scheduled for hepatobiliary surgery under isoflurane anesthesia were studied. Anesthesia was induced with propofol (1.5–2 mg/kg) and remifentanil (2 μg/kg). After tracheal intubation, anesthesia was titrated using isoflurane in oxygen‐enriched air, adjusted to maintain a bispectral index (BIS) value of 46–54. Ephedrine, atropine and remifentanil were used to maintain hemodynamic parameters within 30% of the baseline. The mean arterial blood pressure (MAP), heart rate (HR), drug doses and the time taken to recover from anesthesia were recorded. Results: Demographic data, duration and BIS values were similar in both groups. Anesthesia induction and maintenance were associated with more hemodynamic instability in the patients with jaundice and they received more ephedrine and atropine and less remifentanil and isoflurane (51.1±24.2 vs. 84.6±20.3 mg/min; P for all
ISSN:0001-5172
1399-6576
DOI:10.1111/j.1399-6576.2010.02222.x