الفهرس 
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Abstract
General anaesthesia for cirrhotic patients undergoing liver resection faces the challenge of possible haemodynamic changes, hepatic and renal dysfunction after resection.
The aim is to compare Desflurane (D) versus Sevoflurane (S) based anesthesia in cirrhotic patients undergoing liver resection.
A prospective hospital based comparative study was done including 50 adult cirrhotic patients (Child A) into 2 groups using a simple random method (D group n=25 and S group n=25). During maintenance, increase or decrease of Et Des or Sevoflurane by 1% to keep Entropy (GE, Helsinki, Finland) between 40-60. Liver and kidney functions tests, Urinary Microalbuminuria (Microalb), blood Glutathione-S-transferase (GST), were assayed. Haemodynamics monitored with invasive blood pressure and Trans-oesophageal Doppler monitors. Extubation time, Inhalational agent consumption and cost, intensive care and hospital stay were recorded.
Systemic vascular resistance (SVR) was better preserved with D vs S (835.04±12.02vs778.16±11.97dyn.sec.cm-5, P<0.01) respectively, this was also associated with a higher mean Stroke volume (85.72±2.95vs76.16±6.52 ml, P<0.01) respectively with both CVP and corrected flow time FTc of Doppler within normal ranges throughout surgery. No difference between D and S post resection as regards routine hepatic and renal functions, blood Glutathione-S-Tranferase (GST) (316.96±16.58vs312.48±16.48 IU/ml, P>0.05) and urine Microalbuminuria (7.28±3.35vs7.28±3.35 microgram/ml, P>0.05). Extubation time was significantly shorter in D group (4.52±2 versus 7.72±2 min). Desflurane consumption in ml was significantly higher than Sevoflurane (73±17 vs64±22 ml, P<0.05), but cost was significantly lower. No difference in intensive care and hospital stay (P>0.05).