The effects of different agents preferred for general anesthesia on lactate and liver enzymes in patients undergoing laparoscopic cholecystectomy
The effects of different agents preferred for general anesthesia on lactate and liver enzymes in patients undergoing laparoscopic cholecystectomy
In this study, we aimed to evaluate the effects of different agents used for anesthesia maintenance on liver enzymes and lactate changes in patients undergoing laparoscopic cholecystectomy using CO2 pneumoperitoneum with constant pressure. Seventy-five patients planned to undergo laparoscopic cholecystectomy operation have been randomly divided into 3 groups. Liver function tests have been evaluated preoperatively and postoperatively in the 24th hour. Arterial blood samples for lactate level determination were obtained: (T_1) immediately before pneumoperitoneum, (T_2) 10 min after pneumoperitoneum, (T_3) 30 min after pneumoperitoneum, (T_4) 60 min after desufflation of CO2. Patients scheduled to undergo laparoscopic cholecystectomy operation. The possible effects of different agents used for anesthesia maintenance on liver enzymes and lactate changes in patients undergoing laparoscopic cholecystectomy. In comparison of lactate values, there were no differences between the three groups in T_1, T_2 and T_4 measurements (P=0.059, P=0.108, P=0.225). However, in the T_3 measurements, lactate values are lower in the Group P, compared to Group S and D (P=0.001, P=0.001). Postoperative AST and ALT values are lower in the Group P, compared to Group S and D (P
___
- 1. Himal HS. Minimally invasive ( laparoscopic ) surgery. Surg Endosc. 2002;8:265-70.
- 2. Lal P, Agarwal PN, Malik VK, et al. A difficult laparoscopic cholecystectomy that requires conversion to open procedure can be predicted by preoperative ultrasonography. JSLS. 2002;6:59-63.
- 3. Meftahuzzaman SM, Islam MM, Chowdhury KK, et al. Haemodynamic and end tidal CO2 changes during laparoscopic cholecystectomy under general anaesthesia. Mymensingh Med J. 2013; 22:473-477.
- 4. Alijani A, Hanna GB, Cuschieri A. Abdominal wall lift versus positive pressure capnoperitoneum for laparoscopic cholecystectomy - Randomized controlled trial. Ann Surg. 2004;239:388-94.
- 5. Henny CP, Hofland J. Laparoscopic surgery: pitfalls due to anesthesia, positioning, and pneumoperitoneum. Surg. Endosc. 2005;19:1163-71.
- 6. Saber AA, Laraja RD, Nalbandian HI, et al. Changes in liver function tests after laparoscopic cholecystectomy: not so rare, not always ominous. Am Surg. 2000;66:699-702.
- 7. Morino M, Giraudo G, Festa V. Alterations in hepatic function during laparoscopic surgery. An experimental clinical study. Surg Endosc. 1998;12:968-72.
- 8. Sakorafas G, Anagnostopoulos G, Stafyla V, et al. Elevation of serum liver enzymes after laparoscopic cholecystectomy. N Z Med J. 2005;118:U1317.
- 9. Hasukic S, Kosuta D, Muminhodzic K. Comparison of postoperative hepatic function between laparoscopic and open cholecystectomy. Med Princ Pract. 2005;14:147-50.
- 10. Schilling MK, Redaelli C, Krähenbühl L, et al. Splanchnic microcirculatory changes during CO2 laparoscopy. J Am Coll Surg. 1997;184:378-82.
- 11. Diebel L, Wilson R, Dulchavsky S, et al. Effect of increased intra-abdominal pressure on hepatic arterial, portal venous and hepatic microcirculatory blood flow. J Trauma. 1992;33:279-82.
- 12. Hasukic S. Postoperative changes in liver function tests: randomized comparison of low and high-pressure laparoscopic cholecystectomy. Surg Endosc. 2005;19:1451-5.
- 13. Giraudo G, Brachet Contul R, Caccetta M, et al. Gasless laparoscopy could avoid alterations in hepatic function. Surg Endosc. 2001;15:741-6.
- 14. Guven HE, Oral S. Liver enzyme alterations after laparoscopic cholecystectomy. J Gastrointestin Liver Dis. 2007;16:391-4
- 15. Halevy A, Gold-Deutch R, Negri M, et al. Are elevated liver enzymes and bilirubin levels significant after laparoscopic cholecystectomy in the absence of bile duct injury? Ann Surg. 1994;219:362-4.
- 16. Tan M, Xu FF, Peng JS, et al. Changes in the level of serum liver enzymes after laparoscopic surgery. World J Gastroenterol. 2003;9:364-7.
- 17. Jakimowicz J, Stultiens G, Smulders F. Laparoscopic insufflation of the abdomen reduces portal venous flow. Surg Endosc. 1998;12:129-32.
- 18. Neudecker J, Sauerland S, Neugebauer E, et al. The European Association for Endoscopic Surgery clinical practice guideline on the pneumoperitoneum for laparoscopic surgery. Surg Endosc. 2002;16:1121-243.
- 19. Singal R, Singal RP, Sandhu K, et al. Evaluation and comparison of postoperative levels of serum bilirubin, serum transaminases and alkaline phosphatase in laparoscopic cholecystectomy versus open cholecystectomy. J Gastrointest Oncol. 2015;6:479-86.
- 20. Bickel A, Weiar A, Eitan A. Evaluation of liver enzymes following elective laparoscopic cholecystectomy: are they really elevated? J Gastrointest Surg. 2008;12:1418-21.
- 21. Ibraheim OA, Samarkandi AH, Alshehry H, et al. Lactate and acid base changes during laparoscopic cholecystectomy. Middle East J Anaesthesiol. 2006;18:757-68.
- 22. Ortiz-Oshiro E, Mayol J, Aparicio Medrano JC, et al. Lactate metabolism during laparoscopic cholecystectomy: comparison between CO2 pneumoperitoneum and abdominal wall retraction. World J Surg. 2001;25:980-4.
- 23. Meierhenrich R, Gauss A, Mühling B, et al. The effect of propofol and desflurane anaesthesia on human hepatic blood flow: a pilot study. Anaesthesia. 2010;65:1085-93.
- 24. Zhu T, Pang Q, McCluskey SA, et al. Effect of propofol on hepatic blood flow and oxygen balance in rabbits. Can J Anaesth. 2008;55:364-70.