Medical Journal of The Islamic Republic of Iran (Aug 2007)
Evaluation Indices of Hepatitis-Related Hepatic Cirrhosis and Their Relations to Postoperative Awakening Time
Abstract
Objective:To investigate the anesthesia-postoperative awakening time (AT) of hepatitis- related cirrhosis patients and their relations to grading scores,portal venous pressure (PVP),prealbumin(PA),and age,to predict postoperative AT and provide a basis for adjustment of anesthetic doses during operation. Methods:Atotal of 71 patients with hepatic cirrhosis and hypersplenism at ASAgrade I to II were subject to splenectomy and gastric cardia devascularization under total intravenous anesthesia. The depth control of anesthesia (MAP±20% base value;BIS40-60) and the monitoring of muscular relaxation were taken by HXD-I multifunctional quantitative electroencephalogram monitor. Child-Turcotte-Pugh (CPT) and Model for endstage liver disease (MELD) scoring were carried out prior to operation so that intraoperative PAand PVP as well as postoperative extubation time (ET) and AT were determined. Results: Both ET and postoperative recovery time of the cirrhosis group were significantly longer than those of the non-cirrhosis group (P<0.05). There was a linear relationship between each two variables ET and AT (r=0.962, P<0.001). After the stepwise regression, variables of CTP, PAand PVPwere assigned into the regression equation as AT= -39.7+ 8.3×CTP+0.79×PVP-78.57×PA(the multiple correlation coefficient r=0.942, the coefficient of determination r2=0.887,and the corrected coefficient of determination r2=0.882;F=176.007),(P<0.001).The standard partial regression coefficients of CTP,PA and PVP were 0.460, 0.303 and -0.217,respectively.Conclusion:The anesthesia-postoperative AT of hepatitis-related cirrhosis patients is most closely related to CTP,PVP and PA(CTP>PVP>PA).The anesthesia-postoperative AT can be calculated with the following formula:AT= -39.7+8.3×CTP+0.79×PVP-78.57×PA.
