The effects of desflurane and sevoflurane on hepatic and renal functions after right hepatectomy in living donors*.
We compared postoperative hepatic and renal functions between the two inhalational anesthetics, desflurane and sevoflurane in living donors undergoing right hepatectomy. Seventy-four adult donors were randomly allocated into Des group (n = 37) and sevo group (n = 37). Before the induction of anesthesia, morphine sulfate 400 microg was injected intrathecally. Anesthesia was maintained with one minimum alveolar concentration (MAC) of deflurane or sevoflurane plus continuous intravenous remifentanil. Liver and renal function tests were performed and analysed at preoperative period, immediately after operation, and on 1st, 2nd, 3rd, 5th, 7th, and 30th postoperative days (PODs). Aspartate aminotransferase (AST) showed significant elevations from the day of surgery to POD 3 and alanine aminotransferase (ALT) was significantly elevated on POD 1 and POD 3 in the sevo group. Albumin level was significantly lower on POD 2 in the sevo group. Creatinine was significantly higher on POD 3 and POD 30 and estimated glomerular filtration ratio was significantly lower on POD 3 and POD 30 in the sevo group. No patient developed hepatic or renal failures. The results of our study showed better postoperative hepatic and renal function test with desflurane than sevoflurane at equivalent dose of 1 MAC in living donors undergoing right hepatectomy, but further study is required to evaluate clinical importance.
Ko
Justin S
JS
Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Gwak
Mi S
MS
Choi
Soo J
SJ
Yang
Mikyung
M
Kim
Myung J
MJ
Lee
Jin Y
JY
Kim
Gaab S
GS
Kwon
Choon H D
CH
Joh
Jae W
JW
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000762:Anesthesia Recovery Period; D018685:Anesthetics, Inhalation; D001219:Aspartate Aminotransferases / Q000097:blood; D003404:Creatinine / Q000097:blood; D000077335:Desflurane; D005260:Female; D005919:Glomerular Filtration Rate; D006498:Hepatectomy; D006801:Humans; D007530:Isoflurane / Q000031:analogs & derivatives*; D007677:Kidney Function Tests; D008099:Liver / Q000187:drug effects; D019520:Living Donors; D008297:Male; D008738:Methyl Ethers; D010880:Piperidines / Q000627:therapeutic use*; D000077208:Remifentanil; D000077149:Sevoflurane
D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D010880:Piperidines; D000077149:Sevoflurane; D003404:Creatinine; D000077335:Desflurane; D007530:Isoflurane; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000077208:Remifentanil