1. [The anesthesiological support of liver transplantation].
- Author
-
Kozhevnikov VA, Prokof'ev AA, Meshcheriakov AV, Got'e SV, Shmyrin MM, Vabishchevich AV, Poplavskiĭ IV, Tsirul'nikova OM, Kuznetsov RV, Filin AV, Semenov DIu, and Laptiĭ AV
- Subjects
- Adolescent, Adult, Cadaver, Child, Child, Preschool, Female, Hemodynamics, Humans, Infant, Liver Cirrhosis physiopathology, Liver Cirrhosis surgery, Liver Transplantation physiology, Living Donors, Male, Middle Aged, Monitoring, Intraoperative methods, Preanesthetic Medication methods, Anesthesia methods, Liver Transplantation methods
- Abstract
The choice of anesthesia for a high risk operation, orthotopic transplantation of the liver (OTL), is discussed. The authors propose a protocol of anesthesia for OTL. For induction anesthesia, intravenous drugs should be preferred; the liver-free stage of the operation is carried out under anesthesia with a closed isoflurane contour, and the initial metabolic disorders of patients are corrected. When the bloodflow is let in the transplanted organ, intravenous drugs (ketamine, phentanyl, and benzodiazepines) should be administered in order to reduce the vasodilating effect of isoflurane and vasopressors for preventing relative hypovolemia. At the final stage of anesthesia, isoflurane is used. Before transporting the patient into intensive care ward, phentanyl in a dose of 1.5-3 micrograms/kg was injected, because of rapid elimination of isoflurane and awakening of the patient. This protocol maintained the hemodynamics and the major metabolic parameters at the optimal level.
- Published
- 1999