Book contents
- Personalized Anaesthesia
- Personalized Anaesthesia
- Copyright page
- Contents
- Contributors
- Foreword
- Introduction
- Section 1 Basic Principles
- Section 2 Targeting Effects
- 7 Hypnotic Effect: Inducing Unconsciousness and Emergence from Anaesthesia
- 8 Analgesia: Effects on Response to Nociceptive Stimulation
- 9 Personalized Sedation and Analgesia
- 10 Respiratory Depression
- 11 Immobility
- 12 Effects on Brain Function
- 13 Targeted and Individualized Perioperative Medicine for Cognitive Dysfunction
- 14 Cardiac and Haemodynamic Function
- 15 Effects of Anaesthesia on Thermoregulation
- 16 Effects of Perioperative Management on Kidney Function
- 17 Effects on Liver Function
- 18 Effects on Fluid Balance
- 19 Ventilation during General Anaesthesia
- 20 Epilogue: Artificial Intelligence Methods
- Index
- References
17 - Effects on Liver Function
from Section 2 - Targeting Effects
Published online by Cambridge University Press: 03 December 2019
Book contents
- Personalized Anaesthesia
- Personalized Anaesthesia
- Copyright page
- Contents
- Contributors
- Foreword
- Introduction
- Section 1 Basic Principles
- Section 2 Targeting Effects
- 7 Hypnotic Effect: Inducing Unconsciousness and Emergence from Anaesthesia
- 8 Analgesia: Effects on Response to Nociceptive Stimulation
- 9 Personalized Sedation and Analgesia
- 10 Respiratory Depression
- 11 Immobility
- 12 Effects on Brain Function
- 13 Targeted and Individualized Perioperative Medicine for Cognitive Dysfunction
- 14 Cardiac and Haemodynamic Function
- 15 Effects of Anaesthesia on Thermoregulation
- 16 Effects of Perioperative Management on Kidney Function
- 17 Effects on Liver Function
- 18 Effects on Fluid Balance
- 19 Ventilation during General Anaesthesia
- 20 Epilogue: Artificial Intelligence Methods
- Index
- References
Summary
Liver surgery can be remarkably safe: a zero mortality rate has been achieved with liver resections when patients are properly selected and with meticulous perioperative care [1]. In order to maintain liver function in individual patients undergoing anaesthesia and surgery, the single most important factor is maintaining its perfusion. In order to avoid hypoxic liver injury, preserving sinusoidal blood flow is best done by maintaining an adequate perfusion pressure and avoiding a high central venous pressure. Reducing intraoperative blood loss and maintaining systemic haemodynamics likely play major roles in avoiding hypoxic liver injury. It is still unknown which vasoactive drugs are preferred when haemodynamic instability occurs; Noradrenaline seems to be well tolerated as long as hypovolaemia is avoided. Ischaemic preconditioning and pharmacological preconditioning and postconditioning are promising, but their clinical relevance remains to be determined. Finally there are no good markers of hepatocyte damage that could be used intraoperatively to optimize anaesthetic management.
- Type
- Chapter
- Information
- Personalized AnaesthesiaTargeting Physiological Systems for Optimal Effect, pp. 245 - 256Publisher: Cambridge University PressPrint publication year: 2020
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