[Comparison of epidural fentanyl versus bupivacaine in maintaining intraoperative liver function]

This study was undertaken to evaluate epidural anesthesia in maintaining of intraoperative liver function. Forty six ASA I and II patients undergoing elective open abdominal surgery were randomly allocated to 4 groups (I-IV) ; I (n = 12) : Epidural fentanyl + A, II (n = 12): Epidural fentanyl + B, III (n = 10) : Epidural bupivacaine (0.25%) + A, IV (n = 12) : Epidural bupivacaine + B. A and B patients were hydrated with acetated Ringer at a speed of 20, 10 ml.kg-1.h-1 for the first hour, 10, 5 ml.kg-1.h-1 for the next hour, then 5, 5 ml.kg-1. h-1 respectively, ICG 15 min values (ICG K: indocyanine green disappearance rate, R: retention rate) and AKBR (arterial ketone body ratio) were measured before induction, 10 min after intubation, 20 and 60 min after making a incision and 60 min after extubation. ICG K was larger and ICG R was smaller in I and II than in III and IV. AKBR was higher in I and III than in IV. AKBR in II showed a middle value between I, II and IV. Intraoperative liver function was better-maintained with epidural fentanyl regardless of difference of hydration. The results demonstrated that epidural fentanyl is one of the effective methods of anesthesia in maintaining intraoperative liver function.