실험견에서 간혈류 차단 및 재관류 시 소량의 Nitroglycerin 투여에 의한 간혈류와 실시간 국소 간관류 및 산소 이용률의 변화

Abstract

Background: The Pringle maneuver is traditionally used during the hepatectomy to reduce the blood loss. However, there have been no studies about local liver perfusion (LLP) and oxygen extraction ratio (ero2) following hepatic ischemia and reperfusion. In this study, the changes in hepatic blood flow (HBF)，LLP, ero2 following hepatic ischemia and reperfusion were observed. And the effects of low dose nitroglycerin (NTG) were observed too. Methods: A total of 14 mongrel dogs were divided into two groups; control group (C, n - 7), NTG administration group (N, n - 7), NTG administration was started 5 minutes before HBF occlusion. After femoral arterial and central venous catheterization, midline abdominal incision was made. Hepatic artery (HA) and portal vein (PV) were exposed to clamp and declamp. And then doppla- flowmeter probes were applied on HA and PV to measure their blood flow and a thermal diffusion microprobe was inserted in the liver parenchyme to measure LLP. Results: The HA and PV blood flow, LLP, and ero2 were not different between two groups. However, HBF more increased compared to the baseline level in N group after reperfusion. In C group, LLP did not recover after reperfusion. The LLP in N group recovered to the baseline level after reperfusion. Conclusions: In conclusion, it was observed that the HBF increased and LLP recovered to the baseline level after reperfusion by administration of low dose NTG. The use of low dose NTG is safe and effective for hepatectomy. (Korean J Anesthesiol 2003; 45: 251-257)