[Effect of anesthetic methods on hemodynamics and metabolic changes caused by hepatic ischemia and reperfusion in...

The effects of halothane, isoflurane and epidural anesthesia combined with isoflurane on hemodynamic and metabolic changes caused by hepatic ischemia and reperfusion were studied in 16 pigs. Hepatic arterial and portal venous blood flows were measured electromagnetically. Lactate pyruvate ratio (L/P) and arterial ketone body ratio (AKBR) were calculated as markers of hepatic aerobic metabolism. Total hepatic blood flow (THBF), cardiac output (CO) and THBF/CO showed no significant differences among three anesthetic methods in ischemic and reperfusion period. In the group with epidural anesthesia combined with isoflurane, L/P was significantly lower and AKBR was significantly higher compared with the data obtained in ischemic period. However, hepatic metabolism was severely disturbed after the reperfusion of the liver in all three groups. Especially, halothane group showed the most remarkable decrease in AKBR. In summary, epidural anesthesia will be useful for aerobic hepatic metabolism because of inhibition of the release of endogenous cathecolamines, but hepatic metabolism will not be maintained following hepatic ischemia and reperfusion.