Effects of mannitol in the prevention of lipid peroxidation during liver resection with hepatic vascular exclusion.
OBJECTIVE
To examine the efficacy of mannitol in the prevention of lipid peroxidation during major liver resections performed during hepatic inflow occlusion.


METHODS
Prospective, randomized, open-label study.


METHODS
Aretaieion Hospital, a university-affiliated hospital.


METHODS
30 ASA physical status II and III patients, less than 75 years of age, scheduled for elective liver resection.


METHODS
All patients received combined general and epidural anesthesia. Laparotomy was performed through a bilateral subcostal incision, and hepatectomy was performed by inflow vascular exclusion (Pringle's maneuver). Before this maneuver, and if the patients were hemodynamically stable, they were randomized to receive either mannitol 20% 1.5 mL kg(-1) (group M) or normal saline 1.5 mL kg(-1) (group S) intravenously for 30 minutes.


METHODS
Venous blood malondialdehyde (MDA) concentration, as an index of lipid peroxidation, was measured spectrophotometrically at selected time points.


RESULTS
Patients in both groups presented with raised MDA values (P < 0.05) for the period starting before the release of vascular occlusion until 6 days postoperatively. In patients receiving mannitol, lower MDA values were observed (P < 0.05) compared with group S at the end of operation.


CONCLUSIONS
Mannitol has an antioxidant activity, but we were unable to confirm a positive impact on the postoperative clinical course.
Kostopanagiotou
Georgia
G
2nd Department of Anesthesiology, School of Medicine, University of Athens, Attikon Hospital, Athens 12462, Greece. banesthclin@attikonhospital.gr
Pandazi
Ageliki K
AK
Andreadou
Ioanna
I
Markantonis
Sofia L
SL
Niokou
Dimitra
D
Teloudis
Andreas
A
Costopanagiotou
Constantinos
C
Arkadopoulos
Nikolaos
N
Smyrniotis
Vassilios
V
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000767:Anesthesia, Epidural / Q000379:methods; D000768:Anesthesia, General / Q000379:methods; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D004234:Diuretics, Osmotic / Q000494:pharmacology*; D005260:Female; D006488:Hemostasis, Surgical / Q000379:methods*; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D015227:Lipid Peroxidation / Q000187:drug effects*; D008102:Liver Circulation / Q000187:drug effects; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008353:Mannitol / Q000494:pharmacology*; D008875:Middle Aged; D011446:Prospective Studies; D011517:Prothrombin Time / Q000379:methods; D012965:Sodium Chloride / Q000008:administration & dosage; D013997:Time Factors; D016896:Treatment Outcome
D004234:Diuretics, Osmotic; D008353:Mannitol; D012965:Sodium Chloride; D008315:Malondialdehyde; D001219:Aspartate Aminotransferases; D001663:Bilirubin