• M Abou Hussein, F Mahmoud, R Beltagy, A Hasanin, K Yassen, and A Attar.
• Middle East J Anaesthesiol. 2015 Jun 1; 23 (2): 213-23.

BackgroundMajor liver resection is associated with haemodynamic, hepatic and renal changes as a result of the procedure.AimTo compare Desflurane (D) versus Sevoflurane (S) on hepatic, renal functions, haemodynamics and perioperative course for cirrhotic patients undergoing major liver resection.Patients And MethodsA prospective randomized control study with 50 patients (Child A) (D, n = 25 and S, n = 25). End tidal D or S adjusted with Entropy (40-60). Haemodynamics monitored with invasive blood pressure and trans-oesophageal Doppler (TED). Liver and kidney function tests, blood Glutathione-S-transferase (GST), urinary microalbuminuria (Microalb) were assayed. Extubation time and anaesthetic consumption were recorded.ResultsSystemic vascular resistance (SVR) post-resection and stroke volume of D vs S were 835.04 ± 12.02 vs 778.16 ± 11.97 dyn.sec.cm(-5), P < 0.01, and 85.72 ± 2.95 vs 76.16 ± 6.52 ml, P < 0.01 respectively. Doppler corrected flow time (FTc) between groups were comparable (P > 0.05). No difference post-operatively regarding hepatic and renal functions, and urine Microalb (14.76 ± 3.95 vs l4.24 ± 8.65 µg/ml, P = 0.78), but a statistically difference was found with GST (0.046 ± [symbols: see text], vs 0.043 ± [symbols: see text] IU/ml, P < 0.01). Despite a higher D consumption (73 ± 17 vs 64 ± 22 ml, P = 0.102), cost in Egyptian pounds (LE) was lower with D (141.14 ± 32.90 vs 320.60 ± 114.01, LE, P < 0.01). Extubation time and ICU stay with D vS (4.52 ± 2 vs 7.72 ± 2 min, P < 0.01) and (1.40 0.50 vs 1.64 ± 0.48, days P = 0.09) respectively.ConclusionNeither D nor S were clinically superior to the other with respect to liver and kidneys functions, but D was found to preserve better the haemodynamic parameters and enhance recovery at a lower cost.

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