Essentials of Hepatology

Rivera, Marcus R.; Squires, Robert H.; Davis, Peter J.

doi:10.1016/b978-141603134-5.50032-9

Cited by 3 publications

(2 citation statements)

References 89 publications

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“…If left untreated it leads to worsening cholestasis, hepatic fibrosis, cirrhosis, portal hypertension and liver failure. [12]…”

Section: Biliary Atresiamentioning

confidence: 99%

Anaesthesia for biliary atresia and hepatectomy in paediatrics

Jacob

2012

Indian J Anaesth

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The scope of this article precludes an ‘in depth’ description of all liver problems and I will limit this review to anaesthesia for biliary atresia — a common hepatic problem in the very young — and partial hepatectomy in older children. I will not be discussing the problems of anaesthetising children with hepatitis, cirrhosis, congenital storage diseases or liver failure. Extrahepatic biliary obstruction is an obliterative cholangiopathy of infancy which is fatal if untreated. Diagnosis involves exclusion of other causes of neonatal jaundice and treatment involves a hepatico portoenterostomy carried out at the earliest. This is a review of current concepts in anaesthesia and postoperative management of neonates with extrahepatic biliary atresia. Anaesthesia for hepatic resection has seen great changes in recent times with the improvement in surgical techniques, technology and a better understanding of the underlying physiology. These are reviewed along with the problems of postoperative pain management.

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“…If left untreated it leads to worsening cholestasis, hepatic fibrosis, cirrhosis, portal hypertension and liver failure. [12]…”

Section: Biliary Atresiamentioning

confidence: 99%

Anaesthesia for biliary atresia and hepatectomy in paediatrics

Jacob

2012

Indian J Anaesth

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“…As for any patient with liver dysfunction, the presence of impaired hepatic biotransformation of drugs and diminished synthetic function of coagulation factors and other proteins must be considered during peri-operative management (133). Furthermore, the risk of exacerbation of hepatocellular damage during anesthesia and surgery must be considered (133).…”

Section: Anesthetic Considerationsmentioning

confidence: 99%

Anesthetic considerations for the pediatric oncology patient – part 2: systems‐based approach to anesthesia

Latham

Greenberg

2010

Pediatric Anesthesia

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One of the prices paid for chemo- and radiotherapy of cancer in children is damage to the vulnerable and developing healthy tissues of the body. Such damage can exist clinically or subclinically and can become apparent during active antineoplastic treatment or during remission decades later. Furthermore, effects of the tumor itself can significantly impact the physiologic state of the child. The anesthesiologist who cares for children with cancer or for survivors of childhood cancer should understand what effects cancer and its therapy can have on various organ systems. In part two of this three-part review, we review the anesthetic issues associated with childhood cancer. Specifically, this review presents a systems-based approach to the impact from both tumor and its treatment in children, followed by a discussion of the relevant anesthetic considerations.

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Anesthesia for Patients With Liver Disease

et al. 2014

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Context:Liver plays an important role in metabolism and physiological homeostasis in the body. This organ is unique in its structure and physiology. So it is necessary for an anesthesiologist to be familiar with various hepatic pathophysiologic conditions and consequences of liver dysfunction.Evidence Acquisition:We searched MEDLINE (Pub Med, OVID, MD Consult), SCOPUS and the Cochrane database for the following keywords: liver disease, anesthesia and liver disease, regional anesthesia in liver disease, epidural anesthesia in liver disease and spinal anesthesia in liver disease, for the period of 1966 to 2013.Results:Although different anesthetic regimens are available in modern anesthesia world, but anesthetizing the patients with liver disease is still really tough. Spinal or epidural anesthetic effects on hepatic blood flow and function is not clearly investigated, considering both the anesthetic drug-induced changes and outcomes. Regional anesthesia might be used in patients with advanced liver disease. In these cases lower drug dosages are used, considering the fact that locally administered drugs have less systemic effects. In case of general anesthesia it seems that using inhalation agents (Isoflurane, Desflurane or Sevoflurane), alone or in combination with small doses of fentanyl can be considered as a reasonable regimen. When administering drugs, anesthetist must realize and consider the substantially changed pharmacokinetics of some other anesthetic drugs.Conclusions:Despite the fact that anesthesia in chronic liver disease is a scary and pretty challenging condition for every anesthesiologist, this hazard could be diminished by meticulous attention on optimizing the patient’s condition preoperatively and choosing appropriate anesthetic regimen and drugs in this setting. Although there are paucity of statistics and investigations in this specific group of patients but these little data show that with careful monitoring and considering the above mentioned rules a safe anesthesia could be achievable in these patients.

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Essentials of Hepatology

Cited by 3 publications

References 89 publications

Anaesthesia for biliary atresia and hepatectomy in paediatrics

Anaesthesia for biliary atresia and hepatectomy in paediatrics

Anesthetic considerations for the pediatric oncology patient – part 2: systems‐based approach to anesthesia

Anesthesia for Patients With Liver Disease

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