Blood supply to the liver in the human after 1 MAC desflurane in comparison with isoflurane and halothane

Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
E SchindlerG Hempelmann

Abstract

Objective of this investigation was to compare the effects of the new inhalation agent desflurane with equipotent doses of isoflurane and halothane on hepatic blood flow (tHBF). 36 Patients scheduled for elective aortocoronary bypass grafting were enrolled to the study. tHBF was assessed by plasma clearance and hepatic extraction of indocyanine green, and standard haemodynamic parameters were measured by thermodilution technique. The measurements were performed awake and after intubation at equilibration of 1 MAC. All measurements were terminated before skin incision. We found a significant decrease of tHBF in all patients regardless of the inhalation agent used (H 918 ml/min +/- 107 to 625 ml/min +/- 181, I 930 ml/min +/- 195 to 637 ml/min +/- 137, D 940 ml/min +/- 129 to 677 ml/min +/- 122). The tHBF in relation to cardiac output also decreased significantly (H 17% +/- 5 to 14% +/- 3, I 16% +/- 3 to 14% +/- 5, D 20% +/- 5 to 18% +/- 6). No difference was seen between the groups according to tHBF and haemodynamics. The results of this study suggest that all inhalation agents included in the study significantly decreased tHBF during anaesthesia with the concentration of 1 MAC.

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