Clinical Study Of Anesthesia Management For Liver Transplantation

Part â…  Anesthetic Management and Hemodynamic Monitoring during Liver TransplantationObjective This study was designed to investigate anesthetic management and hemodynamic variation during liver transplantation.Methods Fifty patients with end stage of liver cirrhosis were scheduled to receive orthotopic liver transplantation under general anesthesia. Swan-Ganz catheter was placed via the right internal jugular vein and a catheter was inserted into the right radial artery in order to measure hemodynamic parameters, including arterial blood pressure, pulmonary artery pressure(PAP), pulmonary artery wedge pressure(PAWP),cardiac output(CO), cardiac index(CI), systemic vascular resistance(SVR), pulmonary vascular resistance(PVR), mixed venous oxygen saturation (SvO₂) and blood temperature. Arterial and mixed venous blood samples were taken at preoperation, 30min during pre-anhepatic stage, 5min and 30min of anhepatic stage,5min and 30min during neohepatic stage and the end of operation to measure blood gas.Results Compared with those at preoperation, there were no significant changes in all hemodynamic parameters during pre-anhepatic stage. HR increased and MAP decreased significantly at 5min of anhepatic stage (P<0.05), and furthermore, MAP decreased and plasma K⁺ increased significantly at 5min of neohepatic stage(P<0.05).Plasma Ca₂^+' decreased and blood glucose elevated significantly compared with that of the preoperation (P<0.05).