Liver disease
Conditions
Interventions
intervention group:Goal-oriented optimization of anesthesia strategy
control group:Conventional hemodynamic management
Sponsors
The First Hospital of Jiaxing
Eligibility
Sex/Gender
All
Age
18 Years to 70 Years
Inclusion criteria
Inclusion criteria: 1.Aged 18~70, gender is not limited; 2.The American Society of Anesthesiologists (ASA) classification is graded from I to III; 3.The Child-Pugh classification of liver function is Grade A or B; 4.Elective first laparoscopic hepatectomy; 5.Preoperative assessment showed that the patient's heart, lung, and kidney functions were basically normal, and the patient was able to tolerate surgery and anesthesia; 6.The patient or their legal guardian fully understands the content of this study and voluntarily signs the informed consent form;
Exclusion criteria
Exclusion criteria: 1.Preoperative severe dysfunction or failure of vital organs such as the heart, lungs, brain, and kidneys; 2.Preoperative coagulation dysfunction or long-term use of anticoagulant and antiplatelet drugs, and failure to discontinue medication until the safe window period before surgery; 3.There is severe arrhythmia, such as high-degree atrioventricular block, sick sinus syndrome, etc., or preoperative heart rate <50 beats per minute; 4.There is severe stenosis or occlusion of peripheral arteries, making it impossible to accurately monitor invasive arterial pressure and related hemodynamic parameters; 5.Due to changes in the patient's condition during the operation, a conversion to open surgery was necessary; 6.Emergency surgery, re-hepatectomy, or combined resection of other organs; 7.Pregnant or lactating women; 8.Individuals known to be allergic to the anesthetic drugs used in this study; 9.The patient refused to participate or was unable to cooperate in completing the study;
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Hemodynamic indicators:Heart rate (HR), mean arterial pressure (MAP)Stroke Volume Variability (SVV), Systemic Vascular Resistance Index (SVRI), Cardiac Index (CI), Stroke Volume Index (SVI); | — |
Secondary
| Measure | Time frame |
|---|---|
| Liver function and kidney function;tissue perfusion;Bleeding and transfusion-related indicators:Total intraoperative blood loss (ml), blood loss rate per unit time (ml/h), autologous blood transfusion rate (%), total volume of allogeneic blood transfusion (ml), and allogeneic blood transfusion r;postoperative complications;Total postoperative hospitalization days;The first time of getting out of bed after surgery; | — |
Countries
China
Contacts
Public ContactShen Xu
The First Hospital of Jiaxing
Outcome results
None listed