Evidence Based Practice and Quality Assurance
Background: Living donor hepatectomy (LDH) is now widely used to meet the need for liver grafts due to the shortage of cadaveric livers. Donor safety and perioperative anesthetic management are our major concern; the aim of our study was to compare two anesthetic techniques for management of living donor hepatectomy.
Patients and Methods: After ethical committee approval and informed written consent, 20 donors ASA I physical status undergoing hepatectomy for living related liver transplant were allocated randomly to one of two groups. Group A where anesthesia was induced with fentanyl 2 ug/kg and propofol 2-3 mg · kg−1, and maintained with isoflurane 0.8-1.2% and fentanyl infusion 1-2 mcg · kg−1 · h−1. In group B anesthesia was induced with sufentanyl 0.2 mcg·kg−1, and propofol 2-3mg · kg−1, and maintained with propofol infusion 6-12 mg ·kg−1 h−1 and sufentanyl infusion 0.2-0.4 mcg ·kg−1 · h−1. Atracurium was the muscle relaxant for intubation and maintenance in both groups.
Results: There were no perioperative mortality in both groups, no significant statistical differences between both groups as regard demographic data, duration of operation, hospital stay, intraoperative hemodynamics, blood loss, liver function tests (PT, AST, & ALT) measured in the first, third, and seventh days postoperative.
Conclusion: This study showed that both anesthetic techniques are comparable and well tolerated by the patients undergoing hepatectomy, and the most important is the overall perioperative hemodynamic & fluid management together with postoperative pain management.