Vecuronium Requirements According to the Operation Phase During Liver Transplantation Under Desflurane Anesthesia

Study Overview
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Brief Summary
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The vecuronium requirements may be reduced for recipients of living donor liver transplantation, as the vecuronium is eliminated principally by the liver. Furthermore, the requirements may be different according to the phase of surgery. The requirements may also be different according to the preoperative hepatic function as measured by MELD score during prehepatic phase, or graft to recipient body weight ratio (GRWR) during neohepatic phase. Therefore, the investigators are trying to investigate the difference of vecuronium requirements according to the phase of surgery or MELD score, GRWR.

Detailed Description
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The vecuronium requirements may be reduced for recipients of living donor liver transplantation, as the vecuronium is eliminated principally by the liver. Furthermore, the requirements may be different according to the phase of surgery. The requirements may by further reduced during anhepatic phase of liver transplantation. And the requirements may be increased as the graft functions during neohepatic phase. We also postulated that the requirements may be different according to the preoperative hepatic function during preanhepatic phase, and according to the graft to recipient body weight ratio (GRWR) during neohepatic phase. Therefore, we are trying to investigate the difference of vecuronium requirements according to the phase of surgery, MELD score, GRWR.

Official Title
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Vecuronium Requirements According to the Operation Phase During Liver Transplantation Under Desflurane Anesthesia

Conditions
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Liver Transplantation

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients undergoing elective living donor liver transplantation Exclusion Criteria: patients who can not undergo train-of-four test due to central or peripheral neuromuscular disease. patients with severe cardiopulmonary diseases. patients who received transfusion with more than 10 units of packed red blood cells. primary non-functioning graft immediately after reperfusion of the graft. patients who administered drugs that influences the metabolism of vecuronium (such as anticonvulsant: phenytoin, carbamazepine, primidone, sodium valproate) patients undergoing cadaver donor liver transplantation

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 69 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| High MELD group<br>Preoperative MELD score greater than 20 | |
| Low MELD group<br>Preoperative MELD score lesser than 20 | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| vecuronium requirements during preanhepatic phase | total vecuronium requirements as guided by Train-of-four neuromuscular monitoring during preanhepatic phase | during prehepatic phase of liver transplantation | 
| vecuronium requirements during anhepatic phase | total vecuronium requirements as guided by Train-of-four neuromuscular monitoring during anhepatic phase | during anhepatic phase of liver transplantation | 
| vecuronium requirements during neohepatic phase | total vecuronium requirements as guided by Train-of-four neuromuscular monitoring during neohepatic phase | during neohepatic phase of liver transplantation | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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liver transplantation, vecuronium