Chapter 8

Anesthesia and Pain Control in Liver Surgery

Ney Fuhrmann Leal, Maurício de Oliveira, Vinícius Grando Gava and Silvio Marcio Pegoraro Balzan

Abstract

• Anesthetic management plays a key role in the reduction of perioperative causes of mortality in liver surgery, such as bleeding and liver failure.</p><p> • Intraoperative reduction of the hepatic blood flow can result from changes in blood volume status and also from mechanical or pharmacological effects, and can lead to liver dysfunction.</p><p> • Central venous pressure lower than 5mmHg reduces blood loss during hepatic parenchymal transection.</p><p> • Inhalational anesthetics such as sevoflurane, desflurane, and isoflurane can maintainor even increase total hepatic blood flow; meanwhile, intravenous anesthetics have a modest impact on that.</p><p> • Intraoperative fluid management should not be guided exclusively by central venous pressure, and the use of colloids (such as 5% albumin) as a maintenance and replacement solution reduces extravascular translocation of fluids.</p><p> • Pharmacological preconditioning, mainly with the use of inhaled anesthetics, has been used to prevent ischemia-reperfusion syndrome, although its pathophysiology is not entirely understood.

Total Pages: 106-120 (15)

Purchase Chapter  Book Details