title: Postoperative morphine concentration in infants with or without biliary atresia and its association with hepatic blood flow.
abstract: We measured pre-operative hepatic blood flow and postoperative morphine concentration in infants with or without biliary atresia. Thirty-four infants (0-3 months) with biliary atresia undergoing portoenterostomy (Kasai operation) were included and hepatic blood flow was assessed by magnetic resonance imaging before surgery in 12 of them. Sixteen subjects (0-3 months) without liver disease undergoing abdominal or pelvic surgery acted as controls and six of them had hepatic blood flow assessed. Intravenous morphine (8 μg.kg(-1).h(-1)) was administered to all patients postoperatively. The median (IQR [range]) relative hepatic blood flow was 3.51 (2.72-3.88 [1.68-4.43]) with and 3.15 (2.66-4.42 [2.30-5.01]) without biliary atresia (p = 0.851). The median (IQR [range]) morphine concentration after 24 h infusion was 5.9 (4.5-16.4 [2.9-42.2]) ng.ml(-1) and 6.4 (3.2-12.0 [1.9-48.6]) ng.ml(-1) , respectively (p = 0.460). An inverse regression relation was found between the morphine concentration and the hepatic perfusion index (R(2) = 0.519, p = 0.001). Compensatory increases in hepatic arterial blood flow maintain the total hepatic blood flow in infants with biliary atresia.
authors.affiliation: Department of Anesthesiology, Children's Hospital of Fudan University, Shanghai, China.
authors.forename: X
authors.initials: X
authors.lastname: Wang
authors.forename: Z W
authors.initials: ZW
authors.lastname: Qiao
authors.forename: Z J
authors.initials: ZJ
authors.lastname: Zhou
authors.forename: P J
authors.initials: PJ
authors.lastname: Zhuang
authors.forename: S
authors.initials: S
authors.lastname: Zheng
mesh_terms: D000701:Analgesics, Opioid / Q000097:blood*; D001656:Biliary Atresia / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008099:Liver / Q000098:blood supply; D008102:Liver Circulation; D008279:Magnetic Resonance Imaging; D009020:Morphine / Q000097:blood* / Q000627:therapeutic use; D010149:Postoperative Pain / Q000097:blood / Q000188:drug therapy*; D011171:Portoenterostomy, Hepatic
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine