Anesthesia and hepatic artery ligation

Hospital and anesthesia records of 39 patients who had hepatic artery ligation for severe hepatic trauma were analyzed retrospectively to acquire information on any relationships between choice of anesthetic, preoperative physical condition of the patient, type and incidence of complications, and mortality. Patients who had lost the most blood received neuroleptanalgesia, ketamine, or cyclopropane; those with more stable cardiovascular status received halothane; those in severe circulatory compromise received only oxygen and muscle relaxants. Trends in results of postoperative liver function tests were not related to type of anesthesia. Of the 12 deaths, seven were due to massive bleeding, three to septicemia, one to multiple complications, and one to hepatorenal failure 18 days postoperatively. Choice of anesthetic agent appeared to have no significant influence on postoperative morbidity and mortality; rather, the choice of anesthesia depended on the preoperative physical (especially hemodynamic) status of the patient, which in turn reflected the apparent blood loss estimated at induction.