Objectives: Propofol-based total intravenous anesthesia (TIVA) has been used successfully for liver
transplantation (LT) in recent years. However, there are few discourses in the literature which focus on
the merits and weakness in perioperative management, biochemical changes, and postoperative recovery
between TIVA and desflurane anesthesia (DES).
Methods: We retrospectively compared the circumstances of liver transplantation recipients who had
the surgery carried out under propofol-based TIVA or DES in the period from September 2007 to August
2010. Preoperative characteristics, date of intraoperative management, hemodynamic profiles, concentration
of anesthetics, biochemical changes, and circumstances of postoperative recovery were retrieved
from the hospital database for analysis.
Results: We included 111 patients who received the surgery under either TIVA (n ¼ 66) or DES (n ¼ 45).
Patient demographics, baseline laboratory data, operation time, and fluid management did not differ
between the two groups. In comparison with the DES group, fewer patients had to be administered
norepinephrine (21.2% vs. 42.2%; p ¼ 0.020) in the TIVA group; moreover, the total dosage of norepinephrine
was lower (0.003 ± 0.005 mg vs. 0.006 ± 0.008 mg; p ¼ 0.012) in the TIVA group during liver
reperfusion phase. Blood lactate level was higher in the DES group than in the TIVA group after the
anhepatic phase. TIVA patients woke up faster than those in the DES group (54.0 ± 33.4 minutes vs.
95.0 ± 78.3 minutes; p ¼ 0.034).
Conclusion: Our results suggest that propofol-based TIVA may provide better hemodynamics and
microcirculation during the anhepatic phase in liver transplantation.
Copyright © 2014, Taiwan Society of Anesthesiologists. Published by Elsevier Taiwan LLC. All rights
reserved.