[罂粟摘要]不同类型麻醉药物对肝移植患者术后再灌注综合征的影响:一项单中心回顾性研究

关注罂粟花,共同学习麻醉学最新文献!

不同类型麻醉药物对肝移植患者术后再灌注综合征的影响:一项单中心回顾性研究

贵州医科大学  麻醉与心脏电生理课题

翻译:  安丽

编辑:  严旭

审校: 曹莹

背景: 再灌注综合征(PRS)是指器官移植后，出现突然的血流动力学紊乱。虽然已知PRS会影响肝移植术后的预后，但关于不同类型麻醉药物对PRS的影响知之甚少。本研究探讨了肝移植术中，不同类型麻醉药物的使用与PRS的关系。

方法： 这项单中心回顾性队列研究中，收集了从2016年6月至2019年12月期间接受肝移植的患者398例。根据不同类型麻醉药物的使用将患者分为七氟醚组和丙泊酚组。采用逆概率加权(IPTW)分析，根据血压的记录来探讨PRS与麻醉药物类型之间的关联，同时研究不同类型麻醉药物是否与持续低血压时间以及术后早期预后相关。

结果： 本研究对398例患者资料进行分析，其中丙泊酚麻醉304例(76.4%)，七氟醚麻醉94例(23.6%)。398例患者中有40.7%出现PRS。经过稳定的IPTW分析，七氟醚组与PRS的相关性低于丙泊酚组（优势比，0.47；P=0.018）。然而，使用不同类型的麻醉药物与术后早期预后之间没有相关性。  

结论：七氟醚组出现PRS的比率低于丙泊酚组。虽然在肝移植中不同类型麻醉药物的使用与术后早期预后没有相关性，但选择何种更有利的麻醉药物需进一步研究。

原始文献来源：

Hye-Yeon Cho, Ho-Jin Lee1, Won Ho Kim, Hyung-Chul Lee, Chul-Woo Jung, Suk Kyun Hong, and Seong-Mi Yang. Influence of anesthesia type on post-reperfusion syndrome during liver transplantation: a Single-center retrospective study. AnesthPainMed2022;17:304-311.Doi.org/10.17085/apm.21104.

英文原文：

Influence of anesthesia type on post-reperfusion 

syndrome during liver transplantation: a singlecenter retrospective study

Abstract 

Background: Post-reperfusion syndrome (PRS) results in sudden hemodynamic instability following graft reperfusion. Although PRS is known to influence outcomes following liver transplantation, little is known regarding the effects of anesthetics on PRS. This study investigated the association between the type of anesthetic agent and PRS in liver transplantation. 

Methods: This single-center retrospective cohort study included patients who underwent liver transplantation between June 2016 and December 2019. Patients were divided into sevoflurane and propofol groups according to the anesthetic agent used. Stabilized inverse probability of treatment weighting (IPTW) analysis was performed to investigate the association between PRS identified based on blood pressure recordings and the type of anesthesia. 

Associations between the anesthetic agent and the duration of hypotension as well as early postoperative outcomes were also investigated. 

Results: Data were analyzed for 398 patients, 304 (76.4%) and 94 (23.6%) of whom were anesthetized with propofol and sevoflurane, respectively. PRS developed in 40.7% of the 398 patients. Following stabilized IPTW analysis, the association with PRS was lower in the sevoflurane group than in the propofol group (odds ratio, 0.47; P = 0.018). However, there was no association between the type of anesthetic used and early postoperative outcomes. 

Conclusions: The association of PRS was lower in the sevoflurane group than in the propofol group. However, there was no association between the type of anesthetic and the early postoperative outcomes. Further studies are required to determine the optimal anesthetic for liver transplantation.

打赏