Experimental anaesthesiologic protocol for porto-intracaval shunt for liver total vascular exclusion: Preliminary study in the rabbit

The aim of this study was to evaluate the effects and interference of diffe rent anaesthetic techniques in rabbits undergoing liver total vascular excl usion using a porto-intracaval shunt. Twenty New Zealand rabbits were divid ed in three groups: group A receiving diazepam as premedication, ketamine atropine for induction and maintenance of anaesthesia and underoing a port o-intracaval shunt operation; group B receiving midazolam as premedication, ketamine + fentanyl + atropine for induction and maintenance of anaesthesi a and undergoing a porto-intracaval shunt operation; group C receiving the same drugs as group B but undergoing a simple portal and caval clamping. Th e following parameters were studied: efficacy of premedication, Vital param eters before and after clamping and insertion of the shunt, mean time to cl amp and insert the shunt, mean survival time after clamping (group C) or ac tivation of the shunt (groups A and B). Midazolam was significantly better for premedication; there was no statistically significant difference betwee n groups A and B for the vital parameters, for the time necessary to clamp and insert the shunt, for the intraoperative course, and for the mean survi val time. The absence of a statistically significant difference between gro ups could be due to the low number of animals used in the study. There is a ctually evidence that a correct anaesthesiologic protocol, especially refer ring to analgesia and fluid management, improves the outcome of operated an imals. Surely further studies, possibly conducted on a larger number of ani mals, are required to evaluate better the results observed and to consider applying these data and this experience to humans. (C) 2001 Wiley-Liss, Inc .