Comparison of myocardial protection in pediatric patients undergoing living-donor liver transplantation performed under propofol- versus desflurane-based anesthesia
10.3760/cma.j.cn131073.20220916.00302
- VernacularTitle:丙泊酚和地氟烷对活体肝移植术患儿心肌保护效果的比较
- Author:
Jiahao ZHI
1
;
Yimei CAO
;
Yingli CAO
;
Hengchang REN
;
Lili JIA
;
Yiqi WENG
;
Hongyin DU
;
Wenli YU
Author Information
1. 天津医科大学一中心临床学院，天津 300070
- Keywords:
Desflurane;
Propofol;
Liver transplantation;
Child;
Myocardial injury
- From:
Chinese Journal of Anesthesiology
2023;43(3):265-268
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the myocardial protection in pediatric patients undergoing living-donor liver transplantation (LDLT) performed under propofol- versus desflurane-based anesthesia. Methods:Sixty American Society of Anesthesiologists Physical Status classification Ⅲ or Ⅳ pediatric patients of both sexes, aged 5-24 months, weighing 5-15 kg, scheduled for elective LDLT under general anesthesia, were divided into 2 groups ( n=30 each) using a random number table method: propofol group (group P) and desflurane anesthesia group (group D). During anesthesia maintenance, propofol 5-10 mg·kg -1·min -1 was intravenously infused in group P, desflurane 0.65 MAC-1.30 MAC was inhaled in group D. At 5 min after induction of anesthesia, at 1 h of reperfusion, at the end of surgery, at 1, 2, 3, 7 and 14 days after surgery, and on the day of discharge, the concentrations of serum high-sensitivity cardiac troponin I, creatine kinase isoenzyme, N-terminal pro-B-type natriuretic peptide were determined by enzyme-linked immunosorbent assay, the occurrence of nausea and vomiting, agitation, and shivering, postoperative tracheal extubation time, intensive care unit stay time, and postoperative length of hospital stay were recorded within 24 h after surgery. Results:Compared with group P, the concentrations of serum high-sensitivity cardiac troponin I and creatine kinase isoenzyme were significantly decreased after surgery, the extubation time and intensive care unit stay time were shortened ( P<0.05), and no significant change was found in serum N-terminal pro-B-type natriuretic peptide concentrations, postoperative length of hospital stay and incidence of postoperative adverse effects at each time point in group D ( P>0.05). Conclusions:Desflurane has better myocardial protection than propofol in pediatric patients undergoing LDLT, which is helpful for early prognosis.
