• Users Online: 2045
  • Print this page
  • Email this page
Year : 2019  |  Volume : 63  |  Issue : 3  |  Page : 225-230

Comparison of bispectral index targeted end-tidal concentration of desflurane during three phases of orthotopic liver transplantation

Department of Anaesthesiology, Pain, and Perioperative Medicine, Sir Ganga Ram Hospital, New Delhi, India

Correspondence Address:
Dr. Nitin Sethi
Department of Anaesthesiology, Pain and Peri-Operative Medicine, Sir Ganga Ram Hospital, New Delhi - 110 060
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ija.IJA_693_18

Rights and Permissions

Background and Aims: Reduced inhalational anaesthetic requirement in end-stage liver disease during living donor orthotopic liver transplantation (LD-OLT) is due to increased endogenous opioids. This study evaluated the changes in bi-spectral index (BIS) monitored end-tidal desflurane (ETDes) requirements during ‘dissection’, ‘anhepatic’, and ‘neohepatic’ phases of LD-OLT. Methods: This prospective, cohort study included 40 adults undergoing LD-OLT under general anaesthesia (GA). All patients received BIS-guided desflurane GA. ETDesrequirements in three phases of LD-OLT (primary objective); relationship between inhalational anaesthetic requirements and severity of liver disease; and effect of changes in mean arterial pressure (MAP) and body temperature on ETDesconcentration for all three phases were also evaluated. Results: ETDesduring the ‘dissection’ phase (2.92 ± 0.65%) was > ‘anhepatic’ (2.68 ± 0.85%, P= 0.049) and ‘neohepatic’ phases (2.58 ± 0.71%, P= 0.005). Patients with model of end-stage liver disease (MELD) score < 20 returned significantly greater ETDesthan those with MELD score ≥20 during the ‘dissection’ (MELD <20: 3.11 ± 0.49%; MELD ≥20: 2.58 ± 0.77%, P= 0.01) and ‘anhepatic’(MELD <20: 2.96 ± 0.76%; MELD ≥20: 2.17 ± 0.79%, P= 0.003) phases. A positive correlation was observed between ETDes(r = 0.584, P= 0.001) and temperature in the ‘dissection’ phase only. Conclusion: In patients undergoing LD-OLT, BIS monitoring guidance of depth of desflurane GA suggests lower desflurane requirements during ‘anhepatic’ and the ‘neohepatic’ phase of surgery. Also, the desflurane requirement is greater in patients with lesser severity of liver disease.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded210    
    Comments [Add]    

Recommend this journal