The Effects of Desflurane and Isoflurane on Hepatic and Renal Functions After Right Hepatectomy in Living Donors

초록

Purpose. Considering the severe nature of living donor right hepatectomy (removal of two thirds of the original liver), identification of an anesthetic agent having a minimal impact on postoperative organ function seems important. We compared postoperative hepatic and renal functions between 2 inhalational anesthetics, desflurane (Des) and isoflurane (Iso) among living donors undergoing right hepatectomy. Method. Sixty-four adult donors included in this retrospective study were divided into a Des group (n = 32) and an Iso group (n = 32). Before the induction of anesthesia, morphine sulfate (400 mu g) was injected intrathecally. Anesthesia was maintained with 1 minimum alveolar concentration (MAC) of Des or Iso plus intravenous remifentanil. Hepatic and renal function tests were analyzed preoperatively, immediately after operation, and on the first, second, third, fifth, seventh, and thirtieth postoperative days (POD). Results. Total bilirubin showed significant elevations on POD 1, 5, 7, and 30 in the Des group. Estimated glomerular filtration rate was significantly lower immediately after operation and on POD 1 in the Des group. The postoperative complication rates were similar between the 2 groups, and no patient developed hepatic or renal failure. Conclusion. The present study showed better postoperative hepatic and renal function tests with Iso than Des at an equivalent dose of 1 MAC among living donors undergoing right hepatectomy.

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