الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 150 |  |  |
| | | from | 150 | | |
Abstract
Sevoflurane is a relatively new inhalational anaesthetic agent of low blood : gas partition coefficient with subsequent fast induction and recovery. It is the only available agent which metabolism does not produce TFA and immune based hepatitis after sevoflurane has not been reported. There is concern because a decomposition product of sevoflurane, compound A, is nephrotoxic in rats at ppm concentration that could potentially be achieved in a low-flow system.
Schistosomiasis may be the second important parasitic disease affecting men after malaria. It is one of the most public health problems in Egypt. It affects the liver leading to fibrosis of the hepatic portal tracts, a condition known as schistomal hepatic fibrosis.
The aim of the work was to study the effect of low flow sevoflurane anaesthesia on hepatic and renal functions in patients with schistosomal hepatic fibrosis and compare these effects with those of sevoflurane in non schistosomal patients.
In the present study, 30 adult patients were scheduled for lower abdominal operation, (middle or lower 1/3 uretreic stones). Patients were divided into 2 groups, 15 patients each.
Group I
Non schistosomal patients received sevoflurane 2% in O2 at a total flow rate of 2L-min-1.
Group II
Patients with schistostomal hepatic fibrosis who received sevoflurane 2% in O2 at a total flow rate of 2 L-min-1
Before admission to the operating theatre an intravenous cannula and a foley’s catheter were inserted into each patient and all patients were sedated with 5 mg diazepam. Standard monitoring including ECG, pulse oximeter and automatic non invasive blood pressure cuff were attached to each patient. All patients received continuous epidural analgesia combined with general anaesthesia.
General anaesthesia was induced by propofol 2 mg.Kg-1, fentanyl 1 g.kg-1 and atracurium 0.5 mg.Kg-1 to facilitate tracheal intubation and mechanical ventilation.
In both groups anaesthesia was maintained by sevoflurane (1.5-2.5%) in 100% O2 at total flow rate of 2 L-min-1 using circle system with sodalime absorber.
At the end of operation, neuromuscular block was reversed by intravenous neostigmine and atropine. Extubation followed by oxygenation till full recovery.