title: Effects of desflurane and isoflurane on hepatic and renal functions and coagulation profile during donor hepatectomy.
abstract: We compared the effect of two inhalation anesthetics desflurane and isoflurane on postoperative hepatic and renal functions as well as coagulation profiles in living donors undergoing right hepatectomy. This study was performed on 80 patients who were randomly allocated to group D (desflurane, n = 40) or group I (isoflurane, n = 40) after Faculty Ethics Committee approval. After induction, isoflurane or desflurane was used with air/oxygen for anesthetic maintenance. The isoflurane or desflurane concentration was set at one minimum alveolar concentration (MAC). Remifentanil was infused for analgesia as well as cisatracurium. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), international normalized ratio (INR), albumin, total bilirubin, blood urea nitrogen, creatinine, platelet count, and hemoglobin levels were analyzed preoperatively at end of the operation, and on postoperative days (PODs) 1, 2, 3, 5, 7, and 30. Both AST and ALT differed significantly and continually except on POD 30. AST showed significant elevations from the end of the operation to POD 2 and ALT, from the end of the operation to POD 5 in group I compared with group D. INR was significantly higher from the end of the operation to POD 3 in group I and to POD 2 in group D. At the end of the operation as well as on POD 1 and POD 2, INR was significantly increased in group I compared with group D. Albumin level was significantly lower at the end of the operation in both groups, but it was not different. No patient developed hepatic or renal failure. Our study showed better postoperative hepatic tests and INR using desflurane than isoflurane at equivalent doses of 1 MAC in living donors undergoing right hepatectomy.
authors: Department of Anesthesiology, Medical School of Inonu University, Malatya, Turkey. huseyin.toprak@inonu.edu.tr
authors: H I
authors: HI
authors: Toprak
authors: T
authors: T
authors: Şahin
authors: S
authors: S
authors: Aslan
authors: K
authors: K
authors: Karahan
authors: M
authors: M
authors: Şanli
authors: M Ö
authors: MÖ
authors: Ersoy
mesh_terms: D000328:Adult; D018685:Anesthetics, Inhalation / Q000008:administration & dosage* / Q000009:adverse effects; D015415:Biomarkers / Q000097:blood; D001777:Blood Coagulation / Q000187:drug effects*; D000077335:Desflurane; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects; D006801:Humans; D019934:International Normalized Ratio; D007530:Isoflurane / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology; D007677:Kidney Function Tests; D008099:Liver / Q000187:drug effects* / Q000503:physiopathology / Q000601:surgery*; D008111:Liver Function Tests; D016031:Liver Transplantation / Q000009:adverse effects; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D011237:Predictive Value of Tests; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey; D055815:Young Adult
chemical_list: D018685:Anesthetics, Inhalation; D015415:Biomarkers; D000077335:Desflurane; D007530:Isoflurane