الفهرس 
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Abstract
Liver donors are subjected to specific post-resection haemodynamic changes. Aim is to monitor these changes with a minimal invasive transoesophageal Doppler technique and to evaluate the possible effects of magnesium sulphate infusion (MgSO4) on these haemodynamics changes and total anaesthetic consumption, After Ethics committee approval, a prospective randomized double blinded controlled study involving 50 donors scheduled for right hepatotomy were divided into two equal groups. Controls received saline. MgSO4 group MgSO4 10% (30 mg/ kg over 20 min) administered immediately after induction of anaesthesia, followed by continuous infusion (10 mg /kg/ h) till the end of surgery. Haemodynamic changes monitored with invasive arterial blood pressure and Transoesophageal Doppler (TED) (CardioQ Deltex Medical, Chichester, UK). Anaesthetic depth guided by Entropy. The results were as the following : Lower heart rate with Mg compared to C all over the time P< 0.01. Increase in COP of TED was significantly lower post resection with Mg compared to Controls(C) (5.94±1.18 vs. 7.75 ± 1.78 L/min, P< 0.01) and with less reduction in SVR compared to C (1236.2 ±252 vs. 907.72 ± 237.58 dynes.s/cm5, P<0.01) respectively. No significant difference in TED corrected flow time (FTc) and CVP were reported between both groups at any stage. FTc and CVP during resection were in Mg group 355.84. msec and 5±0.86 mmHg vs. 367.35 msec and 4.60 (0.64) mmHg in C, respectively, P> 0.05. Sevoflurane consumption was lower with Mg 157.1 ± 35.1 vs. 187.6 ± 25.6 ml in C respectively. Reduced fentanyl and rocuronium consumption in Mg group 400.3 ± 63.7 μg and 202. ± Summary 96 26.9 mg vs. 560.0 ±49.90 μg, 271.7±29.4 mg in C respectively (P < 0.01). Operative time and blood loss were7.52±0.7 hour and 500±0.7 ml in Mg versus 7.16±0.74 hour and 498.74 in C. Graft weight were 874.5±137 grams in Mg vs 870±130 grams in C respectively, P>0.05. Extubation time 4.56±1.1 min for Mg versus 9.52±1.93 min for C respectively, P < 0.01. Postoperative patient controlled fentanyl requirements and Visual Analogue Scale (VAS) were lower with Mg vs. C, 70±14.1 μg /h vs. 114±9.09 μg /h and 1.2±0.8 vs. 3.8±.9, respectively (P < 0.01). In conclusion TED was able to detect specific haemodynamic changes associating liver resection. Prophylactic magnesium helped to reduce the hemodynamic changes post-liver resection and lead to a lower anaesthetic consumption with an improvement in postoperative pain relief.