Question

1 what is the major problem during surgery for liver cirrhosis patient

2 What are the risks factors in liver cirrhosis patient for general anestahesia? Explain how do effect of these risk factors on patient.

Answer 1

1. Major problem during surgery for liver Cirrhosis are-

• Hemorrhage
• pleural effusion
• subphrenic infection.
• Pneumothorax
• Bacterial Peritonitis
• Variceal bleedings

2. Risk factors seen in liver Cirrhosis patients for general anesthesia are -

• Right shift in oxygen-hemoglobin curve
• Ascites induced hypoventilation, hypoxemia may occur
• Anemia, leucopenia, thrombocytopenia and coagulopathy
• Encephalopathy
• Renal dysfunction
• Hepatorenal syndome

Surgery and general anesthesia carry increased risks in the patient with cirrhosis. Anesthesia reduces cardiac output, induces splanchnic vasodilation, and causes a 30-50% reduction in hepatic blood flow. This places the cirrhotic liver at additional risk for decompensation.

Various other Causes such as Hepatorenal syndrome can cause kidney Failure due to the Hepatic disease. Encephalopathy can even worsen the condition as NH3 leaked in the Circulation if reached the brain can lead to deleterious Effects on the body of the patient

Patients may even suffer hypoxia and hypoxemia due to the Oxygen Deficiency as a result of which the Oxygen Saturation curve is shifted to The Right side this can Effect patient as It will offer resistance in the patient's Recovery.