Anesthesiological maintenance of orthotopic liver transplantation in children

Objective: to assess the effectiveness of anesthetic maintenance of orthotopic liver transplants in pediatric recipients under conditions of epidural analgesia as a component of general anesthesia. Materials and methods: Twelve children aged between four months and fourteen years who had been involved in the observational research had an orthotopic liver transplant. Anesthetic management included inhalation anesthesia with sevoflurane and thoracic epidural analgesia. Results: hyperdynamia was the most significant, the level of which was closely correlated with the volume of intraoperative blood loss. High level of lactate was not associated with severe acidosis and need not to be corrected. Epidural analgesia did not affect hemodynamic parameters, that allowed to use minimal doses of opioid analgesic, and the safety of anesthesia was undoubtedly increased. The pace and volume of infusion-transfusion support was dictated by the rate and volume of blood loss, while it was important to maintain a rate that was higher than the rate of blood loss. Conclusion: epidural analgesia when orthotopic liver transplants are performed does not create an additional risk for child recipients, including infants, and improves the quality of pain control. The possibility of early extubation of children after orthotopic liver transplantation is determined by the volume of intraoperative infusion. Therefore, it is necessary to improve the methods of calculating the rate and volume of infusion.

ортотопическая трансплантаций печени, севофлюран, эпидуральная аналгезия, гемодинамика, метаболизм, инфузионная терапия, orthotopic liver transplantation, sevoflurane, epidural analgesia, hemodynamics, metabolism, infusion thera