异丙酚和七氟烷对全麻病人短时间吸入纯氧诱发氧化应激反应的影响

目的 评价异丙酚和七氟烷对全麻病人短时间吸入纯氧诱发氧化应激反应的影响.方法 择期拟行开腹手术全麻病人60例,年龄20～60岁,体重50～85kg,ASAⅠ或Ⅱ级,随机分为4组(n=15),各组均依次静脉注射舒芬太尼0.1～0.2 mg/kg、咪达唑仑0.02 mg/kg、异丙酚1～2 mg/kg和罗库溴铵0.6～0.8 mg/kg麻醉诱导,气管插管后行机械通气.麻醉维持:Ⅰ组和Ⅱ组静脉输注异丙酚100～150μg·kg-1·min-1,FiO2分别为40%和100%,Ⅲ组和Ⅳ组吸入1.5%～3.0%七氟烷,FiO2分别为40%和100%,各组均静脉输注瑞芬太尼0.5～1.0μg·kg-1·min-1,间断静脉注射罗库溴铵0.15 mg/kg,维持BIS 40～60.于麻醉诱导前(基础状态)、气管插管后2、4、6h、术后24h时(T1-4)采集动脉血样,测定PaO2、血清8-异前列腺素F2α(8-iso-PGF2α)、MDA浓度和SOD活性,并计算PaO2/FiO2.结果 与基础值比较,T1-3时Ⅰ组、Ⅱ组和Ⅲ组PaO2/FiO2升高,Ⅳ组血清8-iso-PGF2α和MDA浓度升高,SOD活性降低(P<0.05或0.01).与Ⅱ组和Ⅲ组比较,Ⅳ组T1～3时PaO2/FiO2降低,血清8-iso-PGF2α和MDA浓度升高,SOD活性降低(P<0.05).Ⅰ组与Ⅱ组间上述指标比较差异无统计学意义(P>0.05).结论 静脉输注异丙酚100～150μg·kg-1·min-1维持麻醉可抑制全麻病人短时间(≤6 h)吸人纯氧诱发氧化应激反应,而吸入1.5%～3.0%七氟烷维持麻醉则不能.     

异丙酚和七氟烷对全麻病人短时间吸入纯氧诱发氧化应激反应的影响

Objective To investigate the effects of propofol and sevoflurane on oxidative stess response induced by short period pure oxygen inhalation during general anesthesia.Methods Sixty ASA Ⅰ or Ⅱ patients aged 20-60 yr weighing 50-85 kg undergoing elective abdominal surgery under general anesthesia were randomly divided into 2 groups (n=30 each):group propofol (group P) and group sevoflurane (group S).Each group was further divided into 2 subgroups inhaling 40% O2 (P0.4,S0.4) and 100%O2(P1.0,S1.0) respectively during operation.Anesthesia was induced with propofol 1-2 mg/kg,midazolan 0.02 mg/kg and sufentanil 0.1-0.2 mg/kg.Tracheal intobation was facilitated with rocuronium 0.6-0.8 mg/kg.The patients were mechanically ventilated(VT 8 ml/kg,RR 12 bpm).PET CO2 was maintained at 35-40 mmHg.Anesthesia was maintained with in both groups.BIS was maintained at 40-60.Arterial blood samples were collected immediately before induction of anesthesia (baseline),at 2,4,6h after tracheal intubation(T1-3) and 24h after operation(T4) for determination of PaO2,serum 8-iso-PGF2α and MDA concentrations and SOD activity.PaO2/FiO2 was calculated.Results In subgroup S1.0 the serum 8-iso-PGF2α and MDA concentrations were significantly increased while serum SOD activity was significanfly decreased at T1-3 as compared with the baseline.Serum 8-iso-PGF2α and MDA concentrations were significantly higher while serum SOD activity and PaO2/FiO2 were significantly lower at T1-3 in subgroup S1.0 than in stress response induced by≤6h pure O2 inhalation but inhalation of 1.5%-3.0% sevoflurane can not.     

七氟醚对内毒素诱导大鼠肺组织氧化应激反应的影响

目的 探讨七氟醚对内毒素（LPS）诱导大鼠肺组织氧化应激反应的影响。方法Wistar大鼠48只，体重200-290g，随机分为4组（n=12）：对照组（C组）、LPS组（L组）、1．0MAC七氟醚组（S1L组）和1．5MAC七氟醚组（S2L组）。各组大鼠腹腔注射异戊巴比妥钠100mg／kg，麻醉后机械通气。维持呼气末二氧化碳分压在35～45mmHg。L组股静脉注射LPS5mg／kg，C组给予生理盐水1．2ml，S1L组、S2L组注射LPS后分别吸入1．0MAC、1．5MAC七氟醚4h。吸入七氟醚后4h处死大鼠，测定肺组织超氧化物超歧化酶（SOD）、丙二醛（MDA）、一氧化氮（NO）、总一氧化氮合酶（tNOS）水平、诱导型一氧化氮合酶（iNOS）活性及iNOS mRNA、蛋白表达。结果 与C组比较，L组肺组织SOD活性下降，MDA、NO、tNOS水平、iNOS活性及iNOS mRNA及蛋白表达均升高（P〈0．01）；与L组比较，S1L组、S2L组肺组织SOD活性升高，MDA、NO、tNOS水平及iNOS mRNA及蛋白表达降低（P〈0．05）；S1L组与S2L组上述各项指标比较差异无统计学意义（P〉0．05）。结论 吸入1．0MAC和1．5MAC七氟醚4h可减轻LPS诱导肺组织氧化应激反应。     

长期吸入低浓度七氟烷对小鼠生殖功能的影响

目的 评价长期吸入低浓度七氛烷对小鼠生殖功能的影响.方法 ICR雄性小鼠加只,日龄60 d,体重20～25 g,随机分为4组(n=10):对照组(C组);S1-3组分别吸入0.003%、0.01%和0.03%七氟烷.每天2 h,每周连续5 d,持续8周后处死动物.取睾丸和附皋,测定精子活动率、精子数量、精子畸变率、睾丸组织总乳酸脱氢酶(LDH)及乳酸脱氢酶同工酶-X(LDH-X)的活性,并观察睾丸组织超微结构.结果 与C组比较,S3组精子活动率降低、畸变率升高、睾丸组织LDH-X活性降低(P<0.05),S1,2组各指标差异无统计学意义(P>0.05),仅S3组睾丸组织出现病理学改变.结论 长期吸入0.03%七氟烷可导致雄性小鼠生殖功能异常,而长期吸入≤0.01%七氟烷对生殖功能未见影响.     

异丙酚或异氟烷复合麻醉对肺癌根治术病人细胞免疫功能的影响

目的观察异丙酚或异氟烷复合麻醉对肺叶切除术肺癌病人细胞免疫功能的影响。方法择期行肺叶切除术肺癌病人30例,ASAⅠ或Ⅱ级,年龄42～70岁,男女不限。随机分为2组(n= 15)：异丙酚(Ⅳ)组和异氟烷(IH)组,麻醉诱导后气管插管,Ⅳ组静脉输注异丙酚5～12 mg·kg~(-1)·h~(-1),IH组吸入异氟烷,呼气末浓度维持1．3～1．5 MAC,两组分别在血压、心率高于基础值20％以上时,追加0．05～0．1 mg芬太尼。于麻醉诱导前即刻(T_0)、麻醉诱导后10 min(T_1)、切皮后1h(T_2)、麻醉停药即刻(T_1)、术后1h(T_4)及24 h(T_5)采集静脉血,用流式细胞仪测定血浆CD4~+ CD28~+、CD8~+ CD28~+表达率,用ELISA法测血清IFN-γ、IL-12、IL-4浓度,用放射免疫法测定皮质醇浓度。结果与T_0比较,Ⅳ组T_4,时CD4~+ CD28~+、CD8~+ CD28~+升高,T_5时IL-12浓度升高,L_(4,5)时IFN-γ浓度升高,Ⅳ、IH组T(1-5)时皮质醇浓度均升高(P＜0．05或0．01),IH组的变化较Ⅳ组更明显；与T_4比较,Ⅳ组T_5时IFN-γ浓度升高(P＜0．05)。结论与异氟烷复合麻醉比较,异丙酚复合麻醉可增强肺叶切除术肺癌病人细胞免疫功能。     

反复吸入七氟烷对幼年大鼠认知功能的影响

目的 评价反复吸入七氟烷对幼年大鼠认知功能的影响.方法 健康雄性SD大鼠108只,25～35日龄,体重90～100 g,随机分为6组(n=18),C1组、C2组和C3组每天同一时间吸入纯氧0.5 L/min,1 h/次,分别吸入1、3、5 d;S1组、S2组和S3组每天同一时间吸入2.3%七氟烷及纯氧0.5 L/min,1 h/次,分别吸1、3、5 d.干预结束后7 d,各组随机取10只大鼠进行水迷宫实验,记录达标所需训练次数、逃避潜伏期及进入盲端次数;其余8只记录神经电生理强直刺激后群峰电位(PS)振幅,计算长时程增强(LTP)诱发成功率.结果 各组大鼠水迷宫实验达标所需训练次数、逃避潜伏期及进入盲端次数差异无统计学意义(P>0.05).与C3组比较,S3组LTP诱发成功率降低(P<0.05);C1组与S1组比较、C2组与S2组比较差异均无统计学意义(P>0.05).结论 反复吸入七氟烷虽可抑制幼年大鼠LTP形成,但抑制程度较轻,对认知功能无明显影响.     

不同靶浓度异丙酚对七氟醚MAC的影响

目的 评价不同靶浓度异丙酚对七氟醚MAC的影响.方法 择期全麻下行腹部手术的病人,年龄20～50岁,ASA Ⅰ或Ⅱ级,随机分为5组,P0组、P2组、P3组、P4组和P4组均吸入8%七氟醚麻醉诱导,意识消失后静脉注射琥珀胆碱1 mg/kg和瑞芬太尼1 μg/kg.气管插管后行机械通气,P1组、P2组、P3组和P4组靶控输注异丙酚,血浆靶浓度分别为1、2、3、4 tμg/ml,P0组、P1组、P2组、P3组和P4组第1例病人七氟醚呼气末浓度分别为3.0%、2.2%、2.0%、1.8%和1.5%,当七氟醚呼气末浓度平衡15 min以上且神经肌肉功能恢复后开始切皮,根据是否发生切皮反应,采用up-down方法确定下一例病人的七氟醚呼气末浓度,每组出现6个交叉点后终止研究,以6个交叉点病人七氟醚呼气末浓度的均数为MAC.七氟醚MAC与异丙酚血浆靶浓度间分别进行直线回归和等级相关分析.结果 Pn组～P4组七氟醚MAC分别为2.17 4-0.11%、1.90%±0.10%、1.47%±0.19%、1.37%±0.13%和1.00%±0.10%;与P0组相比,P1组～P4组七氟醚MAC均降低,且呈浓度依赖性(P＜0.05).七氟醚MAC(Y)与异丙酚血浆靶浓度(X)间的直线回归方程为Y=2.17-0.212 X,相关系数为-0.946 9(P＜0.05).结论 异丙酚血浆靶浓度1～4 μg/ml可使七氟醚MAC分别降低12%、32%、37%和54%,两者以相加作用的方式抑制切皮反应.     

长期低浓度吸入七氟烷对雌性小鼠生殖激素的影响

目的 探讨长期低浓度吸入七氟烷对雌性小鼠生殖激素的影响. 方法 性成熟雌性昆明小鼠32只,按随机数字表法分为对照组和七氟烷组,其中七氟烷按吸入浓度分为30、100、300 ppm(parts per million,1×10-6)3组,每组8只.七氟烷组每天吸入对应浓度七氟烷6h,连续吸入4周,对照组吸入等量空气.实验前和4周后分别取小鼠静脉血用酶联免疫法检测血清促黄体生成素(serum luteinizing hormone,LH)、促卵泡成熟激素(follicle stimulating hormone,FSH)、雌二醇(estradiol-2,E2)浓度,组织学观察小鼠卵母细胞形态. 结果 对照组、30 ppm组和100 ppm组卵母细胞形态完整,胞质均匀;300 ppm组卵母细胞完整,但胞质出现空泡异常.实验后300 ppm组LH浓度为(3.15±0.52) U/L、FSH(4.9±1.6) U/L,较实验前及其他3组升高(P＜0.05);而实验后300 ppm组E2浓度为(4.9±2.9) pmol/L,较实验前及其他3组也降低(P＜0.05). 结论 慢性吸入低于100 ppm七氟烷对雌性小鼠生殖激素无影响,高于300 ppm可能有生殖损害.     

对比七氟烷与异丙酚对腹腔镜疝囊高位结扎手术患儿认知、应激及疼痛的影响

目的对比七氟烷与异丙酚对腹股沟疝手术患儿认知、应激及疼痛的影响。 方法选取2017年9月至2018年11月重庆市永川区儿童医院90例腹股沟疝患儿,通过随机数字表法分为观察组、对照组,各45例。对照组采用异丙酚静脉麻醉,而观察组采用七氟烷吸入麻醉。比较2组患者的麻醉效果指标,术后1 h、术后1 d以及术后2 d疼痛情况,麻醉诱导前及切皮时应激反应指标,麻醉前、应答后2、4、6、24 h认知功能。 结果观察组麻醉起效时间、呼吸恢复时间短于对照组（P<0.05）。术后1 h、术后1 d及2 d2组的儿童疼痛评分（CHEOPS）随时间延长均下降（P<0.05）,但2组各时间点均无统计学差异（P>0.05）。切皮时与麻醉诱导前比较,2组血清皮质醇（Cor）、去甲肾上腺素（NE）及肾上腺素（E）水平均升高,但观察组均低于对照组（P<0.05）。应答后2、4、6、24 h 2组简易精神状况检查评分（MMSE）随时间变化呈上升趋势（P<0.05）。应答后2、4 h2组MMSE评分低于麻醉前,对照组低于观察组（P<0.05）。 结论相较异丙酚,七氟烷对腹股沟疝手术患儿麻醉效果更佳,可改善其认知功能,抑制机体应激及疼痛。     

择期手术病人七氟醚全麻诱导的效果

目的 比较七氟醚和异丙酚全麻诱导的效果。方法 择期手术病人60例,ASAⅠ级或Ⅱ级,年龄18～64岁,行全身麻醉。随机分为2组（n=30）：七氟醚组（S组）,吸入1MAC七氟醚麻醉诱导;异丙酚组（P组）,靶控输注血浆靶浓度3 mg/L异丙酚麻醉诱导,2组均靶控输注血浆靶浓度4μg/L瑞芬太尼。病人入室静卧5min后记录血压（BP）、心率（HR）作为基础值。记录插管前即刻、插管后1、2、3min的BP和HR以及病人意识消失的时间。结果 与基础值比较,插管前即刻2组BP下降,S组HR减慢（P＜0．01）;插管后1min P组BP下降（P＜0．01）;插管后3min S组BP下降（P＜0．05）。插管后3 min,P组HR较S组快（P＜0．05）。S组意识消失时间短于P组（P＜0．01）。结论 七氟醚用于全麻诱导,是一种安全有效、方便快捷的技术。     

七氟醚吸入麻醉与丙泊酚复合七氟醚麻醉对血糖的影响

目的 探讨七氟醚吸入麻醉对血糖水平的影响.方法 30例全麻患者随机分成七氟醚吸人麻醉组(A组)和丙泊酚复合七氟醚麻醉组(B组),每组15例.观察术前以及手术2h时的血糖浓度.结果 A、B两组手术2h的血糖均比术前明显升高[(6.23±1.45)mmol/L vs.(4.86±0.85)mmol/L和(6.66±1.48)mmol/L vs.(5.11±0.43)mmol/L](P<0.05);但组间差异无统计学意义.结论 七氟醚吸人麻醉与内泊酚复合七氟醚麻醉均不能抑制应激性血糖升高.     

Effects of sevoflurane and propofol on evoked potentials during neurosurgical anesthesia

BACKGROUND: The effect of anesthetics on somatosensory evoked potential (SEP) and auditory brain stem response (ABR) has been a subject of intense reseach over the last two decades. In fact, volatile anesthetics have been repeatedly shown to decrease cortical amplitude in a dose-dependent fashion but the information regarding the effect of propofol is incomplete. The purpose of this study was to compare the effects of sevoflurane and propofol on evoked potentials during comparable depth of anesthesia guided by bispectral index (BIS). METHODS: Forty four patients scheduled for neurosurgery were studied. Anesthesia was maintained with intravenous propofol using target controlled infusion (TCI). We measured the change of amplitude and latency of SEP(N20-P25), ABR (V wave) and visual evoked potential (VEP: P100) at three sets of sevoflurane (0%, 1%, 2%) or propofol concentrations (effect site concentration of 1.5, 2.0, 3.0 microug x ml(-1)). BIS monitor was used to measure relative depth of hypnosis. RESULTS: With increasing concentrations of sevoflurane (0, 1% and 2%), SEP showed dose-related reduction in its amplitude, ABR produced less marked changes and VEP showed a significant reduction at 1%. VEP at the propofol concentration of 3.0 microg x ml(-1) was decreased significantly compared with the amplitude at 1.5 microg x ml(-1) concentration. No significant change was observed with SEP and ABR during the change of propofol dosages. BIS values were almost the same with each anesthetics. CONCLUSIONS: VEP was most strongly affected with anesthetics, and ABR showed less marked influence of sevoflurane and propofol. Propofol based TIVA technique would induce less change in evoked potentials than sevoflurane.     

丙泊酚或异氟醚麻醉对单肺通气时氧化应激反应的影响

目的 观察丙泊酚或异氟醚麻醉对单肺通气(OLV)时氧化应激反应的影响.方法 48例择期行食管癌根治术患者,随机分为丙泊酚单肺通气组(Pro-OLV组)、异氟醚单肺通气组(Iso-OLV组)、丙泊酚双肺通气组(Pro-TLV组)和异氟醚双肺通气组(Iso-TLV组),每组12例.于开胸前(T0)、OLV后(TLV组于开胸后)30 min(T1)、90 min(T2)、150 min(T3)、手术结束时(T4)测定血清超氧化物歧化酶(SOD)、丙二醛(MDA)及NO浓度.结果 与T0时比较,OLV组T1～T4时的SOD活性降低,MDA浓度及NO浓度升高(P<0.01),而TLV组无明显变化.与TLV组比较,OLV组T1～T4时的SOD活性降低,MDA及NO浓度升高(P<0.01).结论 丙泊酚或异氟醚麻醉均不能减轻OLV时氧化应激反应.     

The effects of adding ischemic preconditioning during desflurane inhalation anesthesia or propofol total intravenous anesthesia on pneumoperitoneum-induced oxidative stress

Background: The aim of the study was to explore the differences in oxidative stress during anesthesia with desflurane/N₂O or propofol/remifentanil in patients undergoing laparoscopic cholecystectomy and additionally to evaluate the differential effects of desflurane and propofol on ischemic preconditioning (IP).

Materials and methods: One hundred patients were randomly allocated to four groups. For anesthesia maintenance, the inhalation group (Group I) and the inhalation plus IP group (Group IIP) received desflurane at an end-tidal concentration of 4–6 vol% in oxygen/N₂O, and the TIVA group (Group T) and TIVA plus IP group (Group TIP) received infusions of propofol and remifentanil. In Groups IIP and TIP, IP was carried out by 10?min of pneumoperitoneum followed by 10?min of deflation. Preoperative and postoperative plasma total antioxidant status (TAS), total oxidant status (TOS), paraoxonase, stimulated paraoxonase, arylesterase, ceruloplasmin, and myeloperoxidase levels were analyzed; oxidative stress index (OSI) was calculated.

Results: When oxidative stress parameters were compared between groups, myeloperoxidase values in Group I were statistically significantly lower compared to Group TIP (p?=?.004 with Bonferroni’s correction). There were no differences between preoperative and postoperative TAS, paraoxonase, stimulated paraoxonase, arylesterase, or ceruloplasmin levels (p?>?.05). In intragroup evaluations, postoperative paraoxonase and stimulated paraoxonase levels were found to be lower than preoperative values in Group TIP (p?=?.021 and .012, respectively).

Conclusion: In laparoscopic cholecystectomy lasting less than 60?min, there were no differences in the measured oxidative stress parameters between maintenance of anesthesia by desflurane/N₂O and propofol/remifentanil/N₂O. The addition of 10?min IP administration during both anesthesia techniques did not result in additional changes in the analyzed oxidative stress.     

七氟烷和异丙酚麻醉对肺癌切除术患者围术期炎性反应及肺功能影响的比较

目的 比较七氟烷和异丙酚麻醉对肺癌切除术患者围术期炎性反应及肺功能的影响.方法 选择单纯性左肺下叶切除术患者30例,ASA Ⅰ或Ⅱ级,性别不限,年龄41～64岁,体重指数22～30 kg/m2,随机分为2组(n=15):七氟烷组(S组)和异丙酚组(P组).S组吸入6%～8%七氟烷,静脉注射维库溴铵0.1 mg/kg、芬太尼4～6μg,kg行麻醉诱导,吸入1%～3%七氟烷维持麻醉;P组静脉注射异丙酚2 mg/kg、维库溴铵0.1 mg/kg、芬太尼4～6μg/kg行麻醉诱导,静脉输注异丙酚6～10 nag·kg-1·h-1维持麻醉.于麻醉诱导前(T0)、单肺通气开始前(T1)、单肺通气结束(T2)、关胸(T3)、术后24 h(T4)时取桡动脉血样和混合静脉血样行血气分析,计算肺泡-动脉氧分压差(PA-aO2)、呼吸指数(RI)和肺内分流率(Qs/Qt);于T0、T3、T4时取桡动脉血样,测定血清基质金属蛋白酶-9(MMP-9)和MDA的浓度;于T1、T2、T3时计算肺动态顺应性(Cd).结果 与T0时比较,T1-3,时两组PA-a,O2、RI和Qs/Qt升高,T3时血清MMP-9和MDA浓度升高(P<0.05);与T1时比较,T3时S组Cd降低(P<0.05);与P组比较,S组T3时PA-a O2、血清MMP-9和MDA的浓度升高,T2,3时RI、T1～3时Qs/Qt升高(P<0.05).结论 与七氟烷麻醉比较,肺癌切除术患者采用异丙酚麻醉时围术期炎性反应较低,肺功能损伤相对较轻.     

帕瑞昔布对腹腔镜胆囊切除术后全麻苏醒期应激反应的影响

目的探讨帕瑞昔布对腹腔镜胆囊切除术后全麻苏醒期应激反应的影响。方法择期在全麻下行腹腔镜胆囊切除术患者40例,随机分为芬太尼组（F组）和帕瑞昔布组（P组）,每组20例。所有患者均予丙泊酚、瑞芬太尼、顺阿曲库铵和七氟烷维持麻醉。皮肤缝合时,F组静注芬太尼0．1mg,P组静注帕瑞昔布钠40mg。记录拔管前5rain、拔管时、拔管后5min、10min和15min的MAP、HR、SpO2;记录拔管时Riker镇静躁动评分（SAS）和拔管后15min、30min、1h、2h的视觉模拟评分（VAS）;以酶联免疫吸附测定法检测拔管后1min的血浆肾上腺素、去甲肾上腺素和皮质醇的含量;记录拔管时间和气管拔管并发症发生率。结果与F组比较,P组各观测时间点MAP、HR、VAS和SAS均降低,拔管时间缩短,血浆。肾上腺素、去甲肾上腺素和皮质醇的浓度降低,拔管并发症发生率降低（P〈0．05）,两组SpO2比较差异无统计学意义。结论帕瑞昔布可有效抑制腹腔镜胆囊切除术后瑞芬太尼全麻苏醒期应激反应。     

安氟醚,七氟醚对维库溴铵肌松作用的影响

目的：观察１．０ＭＡＣ的安氟醚或七氟醚对０．０５ｍｇ·ｋｇ－１的维库溴铵临床药效的影响。方法：选择３０例择期手术病人随机分为３组，异丙酚组以异丙酚６～８ｍｇ·ｋｇ－１·ｈ－１及间断追加芬太尼维持麻醉，安氟醚组和七氟醚组分别吸入１．０ＭＡＣ的安氟醚和七氟醚维持麻醉。监测起效时间、最大抑制程度、维持时间、维持剂量。结果：安氟醚组、七氟醚组与对照组在起效时间、最大抑制程度方面的差异无显著性，而在维持时间、维持剂量上的差异则有显著性，分别是对照组的１．９倍、１．８倍和４６．２％、４８．７％。结论：安氟醚和七氟醚能明显延长维库溴铵的维持时间并减少其维持剂量，但对起效时间和最大抑制程度则无明显影响。     

Effects of propofol on hepatic venous oxygen saturation--a comparison with isoflurane or sevoflurane anesthesia

BACKGROUND: We performed a comparative study of propofol versus isoflurane and sevoflurane using continuous monitoring of hepatic venous oxygen saturation (ShvO2) during upper abdominal surgery in 26 patients. METHODS: Anesthesia was induced with propofol 2-2.5 mg x kg(-1) and vecuronium 0.1 mg x kg(-1). Thereafter, Swan Ganz catheters were inserted into the pulmonary artery and hepatic vein. Group P (n=26) patients received continuous propofol infusion and epidural mepivacaine injection for maintenance, while Group I (n=17) received isoflurane and Group S (n=9) received sevoflurane. Systemic oxygen extraction ratio (OERsys) and hepato-splanchnic oxygen extraction ratio (OERspl) were calculated. RESULTS: Heart rate, mean arterial pressure and cardiac index were unchanged after propofol infusion, and isoflurane or sevoflurane inhalation. Propofol at 8 and 10 mg x kg(-1) x h(-1) significantly decreased ShvO2 and increased OERspl, although isoflurane and sevoflurane did not change them. Mixed venous saturation and OERsys were within normal ranges during the studies. CONCLUSIONS: The results suggest that propofol increases the metabolism and oxygen consumption in the liver.