The effects of sevoflurane and isoflurane anaesthesia on renal functions during coronary artery bypass surgery Koroner arter bypass cerrahisinde sevofluran ve izofluran anestezisinin böbrek fonksiyonlari üzerine etkisi(*)

SARICAOĞLU F., Kanbak M., Öcal T., Bomba F., AYPAR Ü.

Anestezi Dergisi, cilt.10, sa.3, ss.207-211, 2002 (Scopus) identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 10 Sayı: 3
  • Basım Tarihi: 2002
  • Dergi Adı: Anestezi Dergisi
  • Derginin Tarandığı İndeksler: Scopus, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.207-211
  • Anahtar Kelimeler: Cardiac surgery, Inorganic fluorid, Isoflurane, NAG, Renal functions, Sevoflurane
  • Lokman Hekim Üniversitesi Adresli: Evet

Özet

Coronary artery bypass surgery (CABGS) has a potential risk for renal functions because of extracorporeal circulation and cardiovascular instability. It has been reported that sevoflurane that widely used for its heamodynamic stability, produces both inorganic fluoride (F.) and Compound A that may cause renal toxicity. In this study, we aimed to investigate the effects of sevoflurane anaesthesia on renal tubular function via determining F. and urinary N-Acetyl-B-Glukozaminidase (NAG) levels in coronary artery bypass surgery. Following ethical committee approval and patient informed consent, a prospective, controlled, randomized study was performed on 20 patients in ASA II-III. Anaesthesia was induced with etomidate, fentanyl and vecuronium and maintained with the mixture of oxygen and nitrous oxide (50-50%), isoflurane (1-1,5%) in Group I (n=10) and sevoflurane (1,5-2%) in Group II (n=10) patients. Blood and urine samples were measured for F. and urine NAG; before induction (T1), at the 30th minute of cardiopulmonary bypass (CPB) (T2), 15 minutes after CPB (T3), at the end of the operation (N), 24th hour after the operation (T5). Blood and urine electrolytes, blood urine nitrogen (BUN), creatinin, uric acid, urine output, blood loss were analyzed at before induction (T1), at the end of the operation (T4) and 24th hour after the operation (T5). Fractional sodium excration (FENa) and creatinin clerence (Cl,creat) are calculated by the values at this times as well. ' [[Demographical data, urine output, blood loss, blood and urine electrolyte levels and FeNa, Cl creat were similar in two groups. Blood and urine F-levels were significantly higher in sevoflurane group but there were no statistically significant difference in NAG levels. We conclude that, sevoflurane did not cause tubular damage in cardiac surgery for short term, although it increased fluorid levels, but its use is still controversial in patients with impaired renal function.