Target-controlled propofol infusion anaesthesia provides better immediate anaesthesia outcome than desflurane anaesthesia in liver transplantation patients

This retrospective comparative study was compared the outcomes in the perioperative management and postoperative recovery which performed in deceased or living donor liver transplantation recipients who received total intravenous anesthesia with propofol versus desflurane anesthesia.

Status

Completed

Phases

Unknown

Study type

Observational

Source

ANZCTR

Registry ID

ACTRN12612000305820

Enrollment

128

Registered

2012-03-16

Start date

2011-01-01

Completion date

Unknown

Last updated

2020-01-13

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

None listed

Brief summary

Total intravenous anesthesia (TIVA) with continuous propofol infusion has been successfully used for liver transplantation (LT). In these reports, a significant increase in propofol plasma concentration was observed in the anhepatic phase; it may lead to over dosage of propofol and compromise the intraoperative hemodynamics. Target-controlled infusion (TCI) device allow anesthesiologists to provide excellent anesthesia by controlling the theoretical concentration of the drug. Wu et al., had demonstrated that the Marsh pharmacokinetic model of TCI is not suitable for LT patients, and suggested that anesthesiologists should use an effective parameter, such as the bispectral index (BIS), spectral entropy or auditory evoked potential (AEP) monitoring, as another guide of propofol to control the TCI pump during LT. In addition, regarding the propofol pharmacokinetics during the anhepatic phase, a case series advocates the usefulness of BIS monitoring to titrate propofol infusion when using TCI anesthesia. The composite A-line autoregressive index (AAI) of the AEP monitoring has been studied as an adequate method to monitor anesthetic depth. The aim of this study was to retrospectively investigate the influence of perioperative anesthetic management and postoperative recovery of TIVA with propofol anesthesia compared to inhalation anesthesia with desflurane during LT.

Interventions

The retrospective comparative study compared the outcomes in the perioperative management and postoperative recovery in deceased or living donor liver transplantation recipients who received total intravenous anesthesia with propofol or desflurane anesthesia at Tri-Service General Hospital. Medical records of all the liver recipients were collected and reviewed from September 2007 to August 2010.

Eligibility

Sex/Gender

All

Age

18 Years to 70 Years

Healthy volunteers

Inclusion criteria

All the liver recipients who received total intravenous anesthesia with propofol or desflurane anesthesia operated at Tri-Service General Hospital from September 2007 to August 2010.

Exclusion criteria

Patients were excluded if they met any of the following criteria: presence of encephalopathy, requirements for pretransplant endotracheal intubation/mechanical ventilation, or use of vasopressors before transplantation.

Outcome results