Category Archives: Uncategorized

Liver resection

Principles:

Keep dry – almost no fluid prior to resection. CVP <5

Then catch up

A-line, CVC, +/- swan sheath

Consider iVC compression by surgeons if hypotensive

Muscle relaxant (consider infusion)

Analgesia options:

  • thoracic epidural
  • spinal diamorphine, wound infusion catheter (2.5mg/ml levo-bupivicaine @ 10ml/hr) + morphine PCA – caution (with liver impairment)
  • role for ESP block?

Links:

https://academic.oup.com/bjaed/article/9/1/1/466205/Anaesthesia-for-hepatic-resection-surgery

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3397643/

http://www.slideserve.com/lamya/liver-resection

http://ether.stanford.edu/library/liver_anesthesia/resections.pdf

https://sthjournalclub.files.wordpress.com/2016/02/anaesthesia-for-hpb-surgery.pdf

http://www.erasuk.net/uploads/2/6/4/0/26401678/4cjupdate_on_eras_for_hpb_surgery.pdf

https://academic.oup.com/bjaed/article/10/1/15/266403/Anaesthesia-for-patients-with-liver-disease

http://www.sciencedirect.com/science/article/pii/S1932227514001347

https://www.openanesthesia.org/liver_surgery_guide/