Influence of epidural anesthesia combined with isoflurane on hepatic ischemia-reperfusion injury

Objective: To determine if epidural anesthesia combined with isoflurane has protective effect on hepatic ischemia-reperfusion injury.Methods: Thirty-six patients with hepatocellular carcinoma were randomized to epidural anesthesia combined with isoflurane group(group E,n=18) and general anesthesia group(group G,n=18).Continuous epidural anesthesia(CEA) was performed at T_8-9 with F 3 in group E.In both groups,anesthesia was induced with midazolam,fentanyl,propofol and vecuronium.The SBP,DBP,HR,IL-6 level and the changes of liver function were measured respectively before anesthesia,after tracheal intubation,pringle maneuver,open pringle maneuver and at the end of operation.Results: The hemodynamic changes were not significant in group E(P<0.05 to P<0.01);Serum IL-6 concentrations increased significantly the moment after tracheal intubation and at the end of operation in group G,compared to those in group E(P<0.05 to P<0.01).The activities of serum aspartate transaminase(AST),alanine transaminase(ALT) increased markedly after reperfusion,compared with those before ischemia in the two groups(P<0.01).Conclusions: Epidural anesthesia combined with isoflurane can reduce the stress response and produce protective effects on the hepatic ischemia-reperfusion injury to some extent.