Abstract:
Background. Donors are volunteers without any health problems. Therefore, the anesthetic
management of donor safety is an important issue. Our aim in this study was to
compare thoracic epidural anesthesia and general anesthesia effects on liver blood flow by
means of liver function tests and indocyanine green and compared with living-donor liver
transplantation.
Methods. Subjects were divided into 2 equal groups: the control group (group I) and the
epidural block group (group II, closed envelope method). In group II patients, the epidural
catheter was inserted at the T6-8 level. In all patients, anesthesia was standardized with the
use of lidocaine, fentanyl, and thiopental. Indocyanine green clearance test values before
general anesthesia (T0), after induction of general anesthesia (T1), after transection (T2),
and at postoperative 24 and 72 hours were recorded. Simultaneously, hemoglobin, hematocrit,
platelet count, prothrombin time (PT), international normalized ratio (INR),
total bilirubin, direct bilirubin, albumin, aspartate transaminase, and alanine transaminase
values were analyzed.
Results. Plasma disappearance rate (PDR) and retention at 15 minutes (R15) of
indocyanine green were not statistically significant difference between groups (P > .05).
Intragroup comparison of PDR and R15 values at times T1, T2, T3, and T4 showed that
the values at T0 were statistically significant (P < .05). PT and INR values were significantly
different for all times within each group (P < .05). It was concluded that the use of thoracic
epidural anesthesia has no effect on global liver function and liver-related liability tests in
patients undergoing elective liver donor surgery.
