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Effect of pharmacological preconditioning with sevoflurane during hepatectomy with intermittent portal triad clamping

Abstract : During hepatectomy, intermittent portal triad clamping (IPC) reduces ischemia-reperfusion injuries. Pharmacological preconditioning with sevoflurane revealed similar properties. The aim of the study was to evaluate the combination of a sevoflurane preconditioning regimen with IPC on ischemia-reperfusion injuries. Three regimens of anesthesia were applied: group SEV with continuous application of sevoflurane, group PRO with continuous propofol infusion and group PC where continuous propofol was substituted by sevoflurane (adjusted to reach MAC∗1.5) for 15 min before IPC. Endpoints were the values of AST and ALT, factor V, prothrombin time, bilirubinemia over the 5-postoperative days (POD), morbidity and mortality at POD30 and POD90. The ALT values at POD5 were lower in the PC group (n = 27) 74 (48 -98) IU/L compared to PRO (n = 26) and SEV (n = 67) respectively 110 (75 -152) and 100 (64 -168) IU/L (p = 0.038). The variation of factor V compared to preoperative values was less important in the PC and SEV groups respectively -14% and -16% vs -30% (PRO) (p = 0.047). Our study suggests that sevoflurane attenuates ischemia-reperfusion injuries on liver function, compared to propofol, without benefit for a specific regimen of pharmacological preconditioning when IPC is applied.
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https://hal.univ-lille.fr/hal-03141798
Contributeur : Lilloa Université de Lille <>
Soumis le : lundi 15 février 2021 - 15:18:57
Dernière modification le : samedi 20 février 2021 - 13:38:32

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Truong Minh Nguyen, Maher Fleyfel, Emmanuel Boleslawski, Lena M'Ba, Marie Geniez, et al.. Effect of pharmacological preconditioning with sevoflurane during hepatectomy with intermittent portal triad clamping. HPB the official journal of the International Hepato Pancreato Biliary Association, 2019, HPB the official journal of the International Hepato Pancreato Biliary Association, 21 (9), pp.1194-1202. ⟨10.1016/j.hpb.2019.01.009⟩. ⟨hal-03141798⟩

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