Document Detail

A clinical prospective comparison of anesthetics sensitivity and hemodynamic effect among patients with or without obstructive jaundice.
MedLine Citation:
PMID:  20236100     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: To compare isoflurane anesthesia in patients with or without hyperbilirubinemia undergoing hepatobiliary surgery. METHODS: Forty-two patients with obstructive jaundice and 40 control patients with normal liver function scheduled for hepatobiliary surgery under isoflurane anesthesia were studied. Anesthesia was induced with propofol (1.5-2 mg/kg) and remifentanil (2 microg/kg). After tracheal intubation, anesthesia was titrated using isoflurane in oxygen-enriched air, adjusted to maintain a bispectral index (BIS) value of 46-54. Ephedrine, atropine and remifentanil were used to maintain hemodynamic parameters within 30% of the baseline. The mean arterial blood pressure (MAP), heart rate (HR), drug doses and the time taken to recover from anesthesia were recorded. RESULTS: Demographic data, duration and BIS values were similar in both groups. Anesthesia induction and maintenance were associated with more hemodynamic instability in the patients with jaundice and they received more ephedrine and atropine and less remifentanil and isoflurane (51.1+/-24.2 vs. 84.6+/-20.3 mg/min; P for all <0.05) than control patients. Despite less anesthetic use, the time to recovery and extubation was significantly longer than that in control. CONCLUSION: Patients with obstructive jaundice have an increased sensitivity to isoflurane, more hypotension and bradycardia during anesthesia induction and maintenance and a prolonged recovery time compared with controls.
L-Q Yang; J-C Song; M G Irwin; J-G Song; Y-M Sun; W-F Yu
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-03-10
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  54     ISSN:  1399-6576     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-23     Completed Date:  2010-10-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  871-7     Citation Subset:  IM    
Department of Anesthesiology, the Second Military Medical University, Shanghai, China.
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MeSH Terms
Anesthesia Recovery Period
Anesthetics / administration & dosage*,  adverse effects*
Blood Pressure / drug effects
Consciousness Monitors
Endpoint Determination
Fluid Therapy
Heart Rate / drug effects
Hemodynamics / drug effects*
Isoflurane / administration & dosage*,  adverse effects*
Jaundice, Obstructive / complications,  physiopathology*
Middle Aged
Prospective Studies
Reg. No./Substance:
0/Anesthetics; 26675-46-7/Isoflurane

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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