Sevoflurane Versus Desflurane on the Incidence of Postreperfusion Syndrome During Living Donor Liver Transplantation: A Randomized Controlled Trial.
BACKGROUND
Various interventions to reduce postreperfusion syndrome during liver transplantation have been explored, but the effect of volatile anesthetics used during liver transplantation on the incidence of postreperfusion syndrome has not been evaluated. A randomized controlled trial was performed to compare the incidence of postreperfusion syndrome between 2 commonly used volatile anesthetics, sevoflurane and desflurane.


METHODS
Sixty-two adult liver recipients scheduled for living-donor liver transplantation were randomized to receive either sevoflurane or desflurane for general anesthesia. The incidence of postreperfusion syndrome, use of vasoactive drugs, and postoperative course were compared. The risk factors associated with postreperfusion syndrome were also analyzed.


RESULTS
There was significantly less postreperfusion syndrome in the sevoflurane group compared to the desflurane group (38.7% vs 77.4%, P = 0.004) and less epinephrine was required in the sevoflurane group than the desflurane group (19.4% vs 45.2%, P = 0.030). Postoperative intensive care unit and hospital length of stay and postoperative course were similar between the groups. Multivariate analysis identified desflurane (compared to sevoflurane) as the only risk factor (odds ratio 7.314, P = 0.001) for reperfusion syndrome.


CONCLUSIONS
When using volatile anesthetics for elective living donor liver transplantation, sevoflurane seems to be a better option than desflurane for reducing the incidence of postreperfusion syndrome.
1 Department of Anesthesiology, Seoul National University Hospital, Seoul, Korea. 2 Department of Anesthesiology, Seoul Metropolitan Government Borame Medical Center, Seoul, Korea.
Jiwon
J
Lee
Yong-Jae
YJ
Yoo
Jung-Man
JM
Lee
Young Jae
YJ
Park
Ho Geol
HG
Ryu
D000328:Adult; D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D000077335:Desflurane; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007530:Isoflurane / Q000008:administration & dosage / Q000031:analogs & derivatives*; D007902:Length of Stay; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D019520:Living Donors; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage*; D008875:Middle Aged; D018579:Patient Selection; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control*; D011446:Prospective Studies; D056910:Republic of Korea; D012307:Risk Factors; D000077149:Sevoflurane; D013577:Syndrome; D013997:Time Factors; D016896:Treatment Outcome
D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D000077335:Desflurane; D007530:Isoflurane