Tremelot L, Restoux A, Paugam-Burtz C, Dahmani S, Massias L, Peuch C, Belghiti J, Mantz J. Interest of BIS monitoring to guide propofol infusion during the anhepatic phase of orthotopic liver transplantation.
ACTA ACUST UNITED AC 2008;
27:975-8. [PMID:
19028068 DOI:
10.1016/j.annfar.2008.10.005]
[Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2007] [Accepted: 10/01/2008] [Indexed: 11/19/2022]
Abstract
OBJECTIVE
The anhepatic phase of orthotopic liver transplantation (OLT) is associated with significant changes in pharmacokinetics. The aim of this study was to compare the influence of this phase on propofol target concentrations during BIS guided target controlled infusion (TCI).
STUDY DESIGN
Prospective study.
PATIENTS AND METHODS
Eight patients aged 25 to 65 years, Child-Pugh status A-B scheduled for OLT were prospectively included. Anesthesia was performed using TCI of propofol (Diprifusor, Marsh pharmacokinetic model), sufentanil and cisatracurium. Propofol target concentration was adjusted to maintain BIS values between 40 and 50.
RESULTS
To maintain stable BIS values, propofol target concentrations should be decreased during the anhepatic phase versus the dissection one (2.0 microg/ml+/-0.8 versus 3.0 microg/ml+/-0.9, p<0.0001).
CONCLUSION
BIS could be useful to titrate propofol infusion during the anhepatic phase of OLT.
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