Effects of hepatic cirrhosis sedative in patients on propofol anesthesia

Objective To investigate the effects of hepatic function on propofol dosage and depth of anesthesia in cirrhotic patients receiving general anesthesia.Methods Patients were divided into three groups according to hepatic function:Child′s class A cirrhosis(group A,n=32),Child's class B cirrhosis(group B,n=26)and normal hepatic function(group C,n=25).The time to lost of consciousness(LOC)after propofol induction,the target concentration and calculated effect site concentrations(Ce)of propofol and total dosages of propofol used at a bispectral index(BIS)level of 50were recorded and compared in the three groups.Results Serum albumin levels were significantly lower in groups A and B compared to group C pre-operatively(P0.05).After surgery,the serum albumin levels and bilirubin levels were significantly lower in patients in group B than those in group C(P0.05).At the time of LOC or BIS 50(BIS values were 50),Ce of propofol were(1.46±0.47) μg/ml and(1.93±0.56)μg/ml respectively,and the amount of propofol used were(0.12±0.03) ml/kg and(0.16±0.04)ml/kg respectively in group B,all of which are significantly lower than the corresponding values in group C[(2.02±0.65)μg/ml,(2.9±1.31)μg/ml,(0.15±0.02)ml/kg and(0.19±0.05)ml/kg]respectively(P0.05).Conclusion Hepatic cirrhosis is associated with a reduction in propofol dosage during TCI induction.The worse the hepatic function is,the less propofol is needed.