Vecuronium Requirements According to the Operation Phase During Liver Transplantation Under Desflurane Anesthesia

Samsung Medical Center35 enrolled

Overview

The vecuronium requirements may be reduced for recipients of living donor liver transplantation, as the vecuronium is eliminated principally by the liver. Furthermore, the requirements may be different according to the phase of surgery. The requirements may also be different according to the preoperative hepatic function as measured by MELD score during prehepatic phase, or graft to recipient body weight ratio (GRWR) during neohepatic phase. Therefore, the investigators are trying to investigate the difference of vecuronium requirements according to the phase of surgery or MELD score, GRWR.

The vecuronium requirements may be reduced for recipients of living donor liver transplantation, as the vecuronium is eliminated principally by the liver. Furthermore, the requirements may be different according to the phase of surgery. The requirements may by further reduced during anhepatic phase of liver transplantation. And the requirements may be increased as the graft functions during neohepatic phase. We also postulated that the requirements may be different according to the preoperative hepatic function during preanhepatic phase, and according to the graft to recipient body weight ratio (GRWR) during neohepatic phase. Therefore, we are trying to investigate the difference of vecuronium requirements according to the phase of surgery, MELD score, GRWR.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Liver Transplantation

Eligibility

Sex: ALLMin age: 20 YearsMax age: 69 Years

Medical Language ↔ Plain English

Inclusion Criteria: * patients undergoing elective living donor liver transplantation Exclusion Criteria: * patients who can not undergo train-of-four test due to central or peripheral neuromuscular disease. * patients with severe cardiopulmonary diseases. * patients who received transfusion with more than 10 units of packed red blood cells. * primary non-functioning graft immediately after reperfusion of the graft. * patients who administered drugs that influences the metabolism of vecuronium (such as anticonvulsant: phenytoin, carbamazepine, primidone, sodium valproate) * patients undergoing cadaver donor liver transplantation

Outcomes

Primary Outcomes

vecuronium requirements during preanhepatic phase

total vecuronium requirements as guided by Train-of-four neuromuscular monitoring during preanhepatic phase

Time frame: during prehepatic phase of liver transplantation

vecuronium requirements during anhepatic phase

total vecuronium requirements as guided by Train-of-four neuromuscular monitoring during anhepatic phase

Time frame: during anhepatic phase of liver transplantation

vecuronium requirements during neohepatic phase

total vecuronium requirements as guided by Train-of-four neuromuscular monitoring during neohepatic phase

Time frame: during neohepatic phase of liver transplantation