Effect of different excipients of propofol on blood lipids and liver function during liver transplantation / 中华麻醉学杂志

ABSTRACT

Objective To investigate the effect of different excipients of propofol on blood lipids and liver function during orthotopic liver transplantation. Methods Forty ASA Ⅲ- Ⅳ patients aged 40-64 yr weighing 50-75 kg undergoing orthotopic liver transplantation were randomly divided into 2 groups ( n = 20 each) propofol medium-chain triglycerides/long-chain triglycerides (MCT/LCT) group (group M) and propofol LCT group (group L). Anesthesia was induced with penehyclidine 1 mg, midazolam 0.04-0.06 mg/kg, sufentanil 0.6-0.8 μg/kg and propofol 1.5-2.0 mg/kg. Tracheal intubation was facilitated with vecuronium 0.10-0.15 mg/kg. The patients were mechanically ventilated. Anesthesia was maintained with 1%-2% isoflurane, continuous infusion of propofol blood samples were collected after admission into the operation room (T1), before skin incision (T2), at the end of pre-anhepatic phase (T3), at the end of anhepatic phase (T4) and 30 and 240 min of neohepatic phase (T5, T6 )for determination of plasma concentrations of triglyceride (TG), total cholesterol (CH), high-density-lipoproteincholesterol (HDL-C), low density-lipoprotein-cholesterol (LDL-C), and activities of aspartate aminotransferase (AST) and alanine aminotransferase (ALT). The changes in parameters from baseline values were calculated. Results Compared with group L, △TG was significant1y decreased at T4-6 in group M ( P ＜ 0.05 ) . There was no significant difference in △CH, △HDL-C, △LDL-C, △AST and △ALT,plasma concentrations of TG,CH, HDL-C and LDL-C,and activities of AST and ALT between the two groups ( P ＞ 0.05). Conclusion The effect of the two formulations of propofol on liver function is comparable. Propofol MCT/LCT exerts less effect on blood lipids during liver transplantation and is more suitable for this type of surgery.