The Effect of Dexmedetomidine as an Adjuvant to Desflurane Anesthesia on Hepatocellular Functions in Patients with Chronic Liver Disease Undergoing Lower Abdominal Surgery: A Randomized Controlled Study

Theodor Bilharz Research Institute

Bibliographic Information

Authors: Mohammed H.B.; Mohammed A.H.; Ali M.Z.; Ibrahim A.A.E.-M.; Saleh M.A.

Journal: Middle East Journal of Anesthesiology

Publisher: American University of Beirut

Publication Date: 2024

Volume / Issue: Volume 31 / Issue 2

Pages: 99–117

ISSN: 5440440

Scopus: View on Scopus

Document Type: Article

Authors and Affiliations

Mohammed H.B., Department of Anesthesia, Surgical Intensive Care, and Pain Management, Faculty of Medicine, Cairo University, Cairo, Egypt; Mohammed A.H., Surgical Intensive Care, and Pain Medicine Department, Theodor Bilharz Research Institute, Giza, Egypt; Ali M.Z., Surgical Intensive Care, and Pain Medicine Department, Theodor Bilharz Research Institute, Giza, Egypt; Ibrahim A.A.E.-M., Department of Anesthesia, Surgical Intensive Care, and Pain Management, Faculty of Medicine, Cairo University, Cairo, Egypt; Saleh M.A., Surgical Intensive Care, and Pain Medicine Department, Theodor Bilharz Research Institute, Giza, Egypt

Abstract

Background: This study aimed to assess the dexmedetomidine (Dex) supplementary effect to desflurane anesthesia in patients with chronic liver disease undergoing elective lower abdominal surgery. Methods: This randomized, double-blind, clinical trial enrolled 82 individuals (30-60 years old) scheduled for elective lower abdominal surgery with body mass index of 18-35 kg/m2, Child-Pugh-Turcotte class A, and American Society of Anesthesiologists physical status II-III. Participants were randomized into the Dex group (receiving Dex at a dosage of 0.1 ug/kg/h in a 20-mL syringe pump diluted with normal saline) and a placebo group. Results: The Dex group revealed a significantly lower heart rate at 5, 10 and 60 min after induction, at 15 and 30 min postoperatively, and upon discharge from the post-anesthesia care unit (PACU). The Dex group also showed a significantly lower systolic blood pressure and mean arterial blood pressure at 5, 10, 15, 30, 45, and 60 min after induction, as well as at 15 and 30 min postoperatively, and discharge from PACU. The Dex group also had lower diastolic blood pressure at 5 and 10 minutes following induction, at 30 min postoperatively, and discharge from PACU. The Dex group also showed lower levels of alanine aminotransferase, gamma-glutamyl transpeptidase after 24 h while and aspartate aminotransferase, total and direct bilirubin after 24 and 48 h. Sedation and satisfaction scores were significantly higher within the Dex group as opposed to the placebo one. Conclusions: Administration of intravenous Dex during desflurane anesthesia resulted in better hemodynamic stability, higher postoperative analgesia and lower affection of hepatic biomarkers than using desflurane anesthesia alone. © 2024, American University of Beirut. All rights reserved.

Keywords

Chronic liver disease; Desflurane; Dexmedetomidine; Hepatocellular functions

Citation Information

Scopus Citations: 0

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