Abstract
The purpose of this study was to estimate hepatic blood flow during halothane (HAL) or isoflurane (ISO) anaesthesia with the noninvasive indocyanine green (ICG) clearance test. Twenty-four ASA status I adult patients, scheduled for elective surgery without liver disease, were allocated into four groups. Before surgery, ICG clearance was measured twice in patients before and after 1, 2 MAC HAL-N2O, 1 and 2 MAC ISO-N2O anaesthesia by ICG clearance meter (Sumitomo Electron-ics™, Japan). This method eliminates the blood sampling and delay of the conventional ICG test. The ICG clearance is displayed in two indices: K (ICG disappearance rate) and R15 (ICG retention rate 15 min after 0.5 mg · kg−1 ICG injection). Indirect blood pressure and heart rate were measured simultaneously. Mean arterial pressure (MAP) decreased by 27, 22 and 29% with 2 MAC HAL-N2O, and with 1 and 2 MAC ISO-N2O groups, respectively (P < 0.05). The ICG clearance was less (P < 0.05) in the 2 MAC HAL-N2O group (K, 0.087 min−1) than with either awake (K, 0.131 min−1) or other groups (K, 0.114 and 0.144 min−1, in the 1 MAC HAL and ISO-N2O groups, respectively) in spite of a similar degree of the depletion of MAP in 2 MAC ISO-N2O group (K, 0.124 min−1). We conclude that isoflurane has a more favourable effect on liver circulation than does halothane.
Résumé
Ce travail vise à évaluer le débit sanguin hépatique pendant l’anesthésie à l’halothane (HAL) ou à l’isoflurane (ISO) par l’épreuve de clairance non invasif du vert d’indocyanine (ICG). Vingt-quatre adultes ASA I exempts de toute affection hépatique, programmés pour une chirurgie non urgente sont répartis en quatre groupes. Avant l’intervention, la clairance de l’ICG est mesurée à deux reprises avant et après une anesthésie HAL-N2O MAC 1 et 2, et ISO-N2O MAC 1 et 2, avec un appareil de mesure d’ICG (Sumitomo Electronics™, Japon). Cette méthode élimine l’échantillonnage sanguin et le délai propre à l’épreuve d’ICG conventionnelle. La clairance de l’ICG est affichée sous deux index: K (la vitesse de disparition de l’ICG) et R15 (le taux de rétention de l’ICG 15 min après l’injection de 0,5 mg · kg−1 d’ICG). La pression artérielle indirecte et la fréquence cardiaque sont mesurées simultanément. La pression artérielle moyenne (PAM) diminue de 27, 22 et 29% respectivement dans le groupe HAL-N2O MAC 2, et dans les groupes ISO-N2O MAC 1 et 2 (P < 0,05). La clairance de l’ICG est moins élevée (P < 0,05) dans le groupe HAL-N2O MAC 2 (K, 0,087 min−1) que soit dans les groupes éveillés (K, 0,131 min−1) ou les autres groupes (K, 0,114 et 0,144 min−1, respectivement, dans les groupes HAL-N2O MAC 1 et ISO-N2O) malgré un niveau de diminution de la PAM identique dans le groupe ISO-N2O MAC 2 (K, 0,124 min−1). Nous concluons que l’isoflurane a un effet plus favorable sur la circulation hépatique que l’halothane.
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Kanaya, N., Iwasaki, H. & Namiki, A. Noninvasive ICG clearance test for estimating hepatic blood flow during halothane and isoflurane anaesthesia. Can J Anaesth 42, 209–212 (1995). https://doi.org/10.1007/BF03010678
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DOI: https://doi.org/10.1007/BF03010678