title: The influence of the severity of chronic virus-related liver disease on propofol requirements during propofol-remifentanil anesthesia.
abstract: OBJECTIVE
  The purpose of this study was to investigate the influence of chronic virus- related liver disease severity on propofol requirements.
  
  
  METHODS
  In this study, 48 male patients with chronic hepatitis B infection were divided into three groups according to Child-Turcotte-Pugh classification of liver function (groups A, B, and C with mild, moderate and severe liver disease, respectively). After intubation, propofol concentration was adjusted by ± 0.3 μg/mL increments to maintain bispectral index in the range of 40-60. Target propofol concentrations at anesthesia initiation, pre-intubation and pre-incision were recorded.
  
  
  RESULTS
  The initial concentration used in group C was significantly lower than that used in group A or B (p<0.05), whereas no difference was observed between groups A and B. At pre-intubation, the actual required concentration of propofol increased significantly (3.2 μg/mL) in group A (p<0.05), which lead to significant differences between the groups (p<0.05). At pre-incision, the requirements for propofol decreased significantly in both groups A and B (3.0 μg/mL and 2.7 μg/mL, respectively) compared with those at pre-intubation (p<0.05), and were significantly different for all three groups (p<0.05), with group C demonstrating the lowest requirement (2.2 μg/mL). The required concentrations of propofol at pre-incision were similar to those at induction.
  
  
  CONCLUSIONS
  In this study, propofol requirements administered by target-controlled infusion to maintain similar depths of hypnosis were shown to depend on the severity of chronic virus-related liver dysfunction. In other words, patients with the most severe liver dysfunction required the least amount of propofol.
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Wu
authors.forename: Su-Qin
authors.initials: SQ
authors.lastname: Huang
authors.forename: Qing-Lian
authors.initials: QL
authors.lastname: Chen
authors.forename: Shu-Sen
authors.initials: SS
authors.lastname: Zheng
mesh_terms: D000328:Adult; D000758:Anesthesia; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D002908:Chronic Disease; D004569:Electroencephalography; D019694:Hepatitis B, Chronic / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D008107:Liver Diseases / Q000150:complications* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010880:Piperidines / Q000008:administration & dosage*; D015742:Propofol / Q000008:administration & dosage*; D000077208:Remifentanil; D014777:Virus Diseases / Q000150:complications* / Q000601:surgery
chemical_list: D018686:Anesthetics, Intravenous; D010880:Piperidines; D000077208:Remifentanil; D015742:Propofol