Postoperative acute kidney injury after volatile or intravenous anesthesia: a meta-analysis

被引:5
作者
Franzen, Stephanie [1 ]
Frithiof, Robert [1 ]
Hultstrom, Michael [1 ,2 ]
机构
[1] Uppsala Univ, Dept Surg Sci Anesthesiol & Intens Care, Uppsala, Sweden
[2] Uppsala Univ, Dept Med Cell Biol, Integrat Physiol, Uppsala, Sweden
关键词
acute kidney injury; iso fl urane; propofol; sevo fl urane; volatile; PROPOFOL-BASED ANESTHESIA; RENAL-FUNCTION; LIVER-TRANSPLANTATION; GENERAL-ANESTHESIA; OXIDATIVE STRESS; SEVOFLURANE; SURGERY; EXPRESSION; ISOFLURANE;
D O I
10.1152/ajprenal.00316.2022
中图分类号
Q4 [生理学];
学科分类号
071003 ;
摘要
Postoperative acute kidney injury (AKI) is a common complication after surgery. The pathophysiology of postoperative AKI is complex. One potentially important factor is anesthetic modality. We, therefore, conducted a meta-analysis of the available lit-erature regarding anesthetic modality and incidence of postoperative AKI. Records were retrieved until January 17, 2023, with the search terms ("propofol" OR "intravenous") AND ("sevoflurane" OR "desflurane" OR "isoflurane" OR "volatile" OR "inhala-tional") AND ("acute kidney injury" OR "AKI"). A meta-analysis for common effects and random effects was performed after exclusion assessment. Eight records were included in the meta-analysis with a total of 15,140 patients (n = 7,542 propofol and n = 7,598 volatile). The common and random effects model revealed that propofol was associated with a lower incidence of postoperative AKI compared with volatile anesthesia [odds ratio: 0.63 (95% confidence interval: 0.56-0.72) and 0.49 (95% confidence interval: 0.33-0.73), respectively]. In conclusion, the meta-analysis revealed that propofol anesthesia is associated with a lower incidence of postoperative AKI compared with volatile anesthesia. This may motivate choosing propofol-based anesthesia in patients with increased risk of postoperative AKI due to preexisting renal impairment or surgery with a high risk of renal ischemia. NEW & NOTEWORTHY This study analyzed the available literature on anesthetic modality and incidence of postoperative AKI. The meta-analysis revealed that propofol is associated with lower incidence of AKI compared with volatile anesthesia. It might therefore be considerable to use propofol anesthesia in surgeries with increased susceptibility for developing renal injuries such as cardiopulmonary bypass and major abdominal surgery.
引用
收藏
页码:F329 / F334
页数:6
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