Comparative effect of propofol versus sevoflurane on renal ischemia/reperfusion injury after elective open abdominal aortic aneurysm repair

被引:18
作者
Ammar, A. S. [1 ]
Mahmoud, K. M. [1 ]
机构
[1] Minoufiya Univ, Minoufiya Fac Med, Dept Anesthesiol, Al Minufiyah, Egypt
关键词
Propofol; renal ischemia-reperfusion injury; sevoflurane;
D O I
10.4103/1658-354X.174907
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Background: Renal injury is a common cause of morbidity and mortality after elective abdominal aortic aneurysm (AAA) repair. Propofol has been reported to protect several organs from ischemia/reperfusion (I/R) induced injury. We performed a randomized clinical trial to compare propofol and sevoflurane for their effects on renal I/R injury in patients undergoing elective AAA repair. Materials and Methods: Fifty patients scheduled for elective AAA repair were randomized to receive propofol anesthesia in group I or sevoflurane anesthesia in group II. Urinary specific kidney proteins (N-acetyl-beta-glucosamidase, alpha-1-microglobulin, glutathione transferase [GST]-pi, GST-alpha) were measured within 5 min of starting anesthesia as a base line (T-0), at the end of surgery (T-1), 8 h after surgery (T-2), 16 h after surgery (T-3), and 24 h postoperatively (T-4). Serum pro-inflammatory cytokines (tumor necrosis factor-a and interleukin 1-beta) were measured at the same time points. In addition, serum creatinine and cystatin C were measured before starting surgery as a baseline and at days 1, 3, and 6 after surgery. Results: Postoperative urinary concentrations of all measured kidney specific proteins and serum pro-inflammatory cytokines were significantly lower in the propofol group. In addition, the serum creatinine and cystatin C were significantly lower in the propofol group compared with the sevoflurane group. Conclusion: Propofol significantly reduced renal injury after elective open AAA repair and this could have clinical implications in situations of expected renal I/R injury.
引用
收藏
页码:301 / 307
页数:7
相关论文
共 33 条
[11]   Nephrotoxicity of sevoflurane versus desflurane anesthesia in volunteers [J].
Eger, EI ;
Koblin, DD ;
Bowland, T ;
Ionescu, P ;
Laster, MJ ;
Fang, ZX ;
Gong, D ;
Sonner, J ;
Weiskopf, RB .
ANESTHESIA AND ANALGESIA, 1997, 84 (01) :160-168
[12]   Propofol attenuates human proximal renal tubular epithelial cell injury induced by anoxia-reoxygenation [J].
Feng, Yani ;
Bai, Tao ;
Ma, Hong ;
Wang, Jun-Ke .
LABMEDICINE, 2008, 39 (06) :356-360
[13]   Serum cystatin C concentration as a marker of renal dysfunction in the elderly [J].
Fliser, D ;
Ritz, E .
AMERICAN JOURNAL OF KIDNEY DISEASES, 2001, 37 (01) :79-83
[14]   EFFECTS OF INFRARENAL AORTIC CROSS-CLAMPING ON RENAL HEMODYNAMICS IN HUMANS [J].
GAMULIN, Z ;
FORSTER, A ;
MOREL, D ;
SIMONET, F ;
AYMON, E ;
FAVRE, H .
ANESTHESIOLOGY, 1984, 61 (04) :394-399
[15]   EFFECTS OF RENAL SYMPATHETIC BLOCKADE ON RENAL HEMODYNAMICS IN PATIENTS UNDERGOING MAJOR AORTIC ABDOMINAL-SURGERY [J].
GAMULIN, Z ;
FORSTER, A ;
SIMONET, F ;
AYMON, E ;
FAVRE, H .
ANESTHESIOLOGY, 1986, 65 (06) :688-692
[16]   Effects of sevoflurane and isoflurane on renal function and on possible markers of nephrotoxicity [J].
Higuchi, H ;
Sumita, S ;
Wada, H ;
Ura, T ;
Ikemoto, T ;
Nakai, T ;
Kanno, M ;
Satoh, T .
ANESTHESIOLOGY, 1998, 89 (02) :307-322
[17]   MECHANISM OF GLOMERULOTUBULAR BALANCE IN THE SETTING OF HETEROGENEOUS GLOMERULAR INJURY - PRESERVATION OF A CLOSE FUNCTIONAL LINKAGE BETWEEN INDIVIDUAL NEPHRONS AND SURROUNDING MICROVASCULATURE [J].
ICHIKAWA, I ;
HOYER, JR ;
SEILER, MW ;
BRENNER, BM .
JOURNAL OF CLINICAL INVESTIGATION, 1982, 69 (01) :185-198
[18]   Permanent renal failure induced by pentastarch [J].
Jamal, Rahima ;
Ghannoum, Marc ;
Naud, Jean-Francois ;
Turgeon, Pierre-Paul ;
Leblanc, Martine .
CLINICAL KIDNEY JOURNAL, 2008, 1 (05) :322-325
[19]  
Kharasch ED, 2005, ANESTHESIOLOGY, V103, P1183
[20]   Assessment of low-flow sevoflurane and isoflurane effects on renal function using sensitive markers of tubular toxicity [J].
Kharasch, ED ;
Frink, EJ ;
Zager, R ;
Bowdle, TA ;
ARtru, A ;
Nogami, WM .
ANESTHESIOLOGY, 1997, 86 (06) :1238-1253