Effect of Sevoflurane and Propofol on Hepato-splanchnic Pressure and Flow During Hepatobiliary Surgery
Status:
Completed
Trial end date:
2018-12-04
Target enrollment:
Participant gender:
Summary
Blood loss in hepatobiliary surgery is correlated with an increase in postoperative
complications (e.g. transfusion related lung injury and tumor recurrence) and reduced
longterm survival. To reduce morbidity and mortality in hepatobiliary surgery, modulation of
the hepato-splanchnic blood flow and pressure is used. In liver surgery pharmacological
modulations are widely used to prevent blood loss. For pharmacological modulation central
venous pressure is commonly used to reduce the pressure in the inferior vena cava, however
little is known about pharmacological effect on blood flow in the hepatic artery and portal
vein. The modulation of the hepato-splanchnic blood flow can also play an important role, not
only for prevention of blood loss but also for survival of the organs (e.g. ischemic injury
due to low flow).
Volatile anesthetics induce a dose-dependent reduction of the hepato-splanchninc blood flow.
Propofol however, increases hepatic blood flow when compared with volatile anesthetics.
Pharmacological modulation of hepato-splanchnic bloodflow with anesthetics such as
sevoflurane or propofol can play an important role in modulation of ischemia/reperfusion
injury and survival of organs.
The aim of the study is to determine and to compare the effect of sevoflurane versus propofol
on hepatosplanchnic pressure and hepato-splanchnic blood flow during hepatobiliary surgery.