Changes in dose requirements of rocuronium after right hemihepatectomy in donor for liying donor liver transplantation / 中华麻醉学杂志

ABSTRACT

Objective To investigate the changes in the dose requirements of rocuronium after right hemihepatectomy in donor of living donor liver transplantation. Methods Sixteen ASA Ⅰ patients of living donor liver transplantation, aged 21-49 yr, weighing 51-86 kg, scheduled for right hemihepatectomy, were enrolled in this study. Anesthesia was induced with iv midazolam and fentanyl, and TCI of propofol and rocuronium. Changes in adductor pollicis muscle were monitored by the train of four (TOF) stimulation. The patients were mechaincally ventilated after tracheal intubation when T1/Tc = 0. The target plasma concentration of rocuroniurn was reduced to 1.0 μg/ml after tracheal intubation and the concentration was regulated to maintain 0 < T1 ≤ 10%. Anesthesia was maintained with sevoflurane inhalation, TCI of propofol, intermittent iv injection of fentanyl. The infusion of rocuronium and inhalation of sevoflurane were stopped before the second time of cholangiography, the total time and amount of rocuronium administered and the recovery of muscle relaxation were recorded at this time (before hemihepatectomy). The infusion of rocuronium and inhalation of sevoflurune were rests-ted after right hemibepatectomy. After the peritoneum was closed, the infusion of rocuroniurn and inhalation of sevoflurane were stopped again, the total time and amount of rocuronium administered and the recovery of muscle relaxation were also recorded at this time (after hemihepatectomy). Results The amount of rocuronium administered was significantly reduced after hemihepatectomy compared with that before hernihepatectomy (P < 0.05). The amount of rocurunium administered after hemihepatectomy was (67 ± 13) % of that before hemihepatectomy. Conclusion Right hemihepatectomy can affect the metabolism of rocuronium in the donor of living donor liver transplantation.