Abstract
We have previously reported that prostaglandin E, maintained the estimated hepatic blood flow during sevoflurane anesthesia. In the present study, we investigated the effects of diltiazem on the hepatic blood flow during sevoflurane anesthesia by detecting the indocyanine green (ICG) clearance rate using a finger-piece method, which is the same method as in the previous study. Eight patients scheduled for arthroscopic knee surgery were chosen and they received simultaneously anesthesia consisting of N2O-O2-1.7% sevoflurane and an intravenous drip administration of 5μg•kg-1•min-1 of diltiazem (D-group). The results obtained from the D-group were compared with those of the group receiving only sevoflurane anesthesia (S-group, n=8), from the previous study. The ICG clearance rate and cardiac output (CO) using an impedance method were measured both before anesthesia and two hours after the start of anesthesia in both groups. The ICG clearance rate decreased to 63% and CO decreased to 71% of their respective baseline values in the S-group, but they were maintained at 95% and 103% in the D-group, which were significantly higher than the values of the S-group. The present study indicates that administration of a small dose of diltiazem during sevoflurane anesthesia could produce a protective effect on hepatic circulation by maintaining CO as prostaglandin E1, whereas sevoflurane decreased CO and the estimated hepatic blood flow.
