title: Effects of Thoracic Epidural Anesthesia on Liver Blood Flow and Indocyanine Green Clearance Test in Living-Donor Liver Transplantation: A Prospective, Randomized, Double-Blind Study.
abstract: BACKGROUND
  Donors are volunteers without any health problems. Therefore, the anesthetic management of donor safety is an important issue. Our aim in this study was to compare thoracic epidural anesthesia and general anesthesia effects on liver blood flow by means of liver function tests and indocyanine green and compared with living-donor liver transplantation.
  
  
  METHODS
  Subjects were divided into 2 equal groups: the control group (group I) and the epidural block group (group II, closed envelope method). In group II patients, the epidural catheter was inserted at the T6-8 level. In all patients, anesthesia was standardized with the use of lidocaine, fentanyl, and thiopental. Indocyanine green clearance test values before general anesthesia (T0), after induction of general anesthesia (T1), after transection (T2), and at postoperative 24 and 72 hours were recorded. Simultaneously, hemoglobin, hematocrit, platelet count, prothrombin time (PT), international normalized ratio (INR), total bilirubin, direct bilirubin, albumin, aspartate transaminase, and alanine transaminase values were analyzed.
  
  
  RESULTS
  Plasma disappearance rate (PDR) and retention at 15 minutes (R15) of indocyanine green were not statistically significant difference between groups (P > .05). Intragroup comparison of PDR and R15 values at times T1, T2, T3, and T4 showed that the values at T0 were statistically significant (P < .05). PT and INR values were significantly different for all times within each group (P < .05). It was concluded that the use of thoracic epidural anesthesia has no effect on global liver function and liver-related liability tests in patients undergoing elective liver donor surgery.
authors.affiliation: Department of Anesthesiology and Reanimation, Inonu University, Faculty of Medicine, Malatya, Turkey.
authors.forename: H
authors.initials: H
authors.lastname: Sayan
authors.affiliation: Department of Anesthesiology and Reanimation, Inonu University, Faculty of Medicine, Malatya, Turkey. Electronic address: mustafa.aydogan@inonu.edu.tr.
authors.forename: M S
authors.initials: MS
authors.lastname: Aydogan
authors.affiliation: Department of Anesthesiology and Reanimation, Inonu University, Faculty of Medicine, Malatya, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Bıcakcıoğlu
authors.affiliation: Department of Anesthesiology and Reanimation, Inonu University, Faculty of Medicine, Malatya, Turkey.
authors.forename: H I
authors.initials: HI
authors.lastname: Toprak
authors.affiliation: Department of General Surgery, Inonu University, Faculty of Medicine, Malatya, Turkey.
authors.forename: B
authors.initials: B
authors.lastname: Isık
authors.affiliation: Department of General Surgery, Inonu University, Faculty of Medicine, Malatya, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Yılmaz
mesh_terms: D000328:Adult; D000767:Anesthesia, Epidural / Q000379:methods*; D004396:Coloring Agents / Q000493:pharmacokinetics; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007208:Indocyanine Green / Q000493:pharmacokinetics*; D008099:Liver / Q000098:blood supply*; D008102:Liver Circulation / Q000502:physiology*; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D011184:Postoperative Period; D011446:Prospective Studies; D013904:Thoracic Vertebrae
chemical_list: D004396:Coloring Agents; D007208:Indocyanine Green