Influence of General Anaesthesia on Portal Pressure in Liver Cirrhosis and Portal Hypertension

Abstract

In 19 patients with cirrhosis of the liver and portal hypertension, a catheter was inserted into the portal vein using a percutaneous transhepatic technique. The portal pressure was measured during general anaesthesia with and without halothane, and in the awake state. Addition of halothane to the N2O:O2 anaesthesia did not change portal venous pressure, in spite of a significant fall in arterial blood pressure. Portal venous pressure under general anaesthesia with complete muscle relaxation did not differ from the pressure in the resting, awake patient.

Effects of General Anaesthesia on Portal Venous Pressure in the Rat

“…This assertion is based on the previously reported relationship between the decrease in cardiac output induced by propranolol and the reduction in portal venous pressure in patients with cirrhosis [6]. In a small group of patients with cirrhosis [1], no significant change in portal venous pressure, measured directly by the transhepatic technique, was noted during general anaesthesia partly induced by halothane. However, previous inves tigations demonstrated that cardiac output decreases in a linear fashion with increasing concentrations halothane [5] and, in this patient series, halothane inhalation might have been insufficient to obtain a sustained decrease in cardiac output and, therefore, in portal venous pressure.…”