Kidney Function in Living Donors Undergoing Nephrectomy by Sevoflurane or Desflurane Anesthesia
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: Although there is no clinical evidence of nephrotoxicity with the volatile anesthetics currently used in general anesthesia, a better agent should be needed in terms of preserving postoperative renal function in living kidney donors who have only single remaining kidney. The purpose of the current retrospective, single-center study was to evaluate and compare renal function of living kidney donors after nephrectomy under either sevoflurane or desflurane anesthesia. Materials and Methods: From January 2006 through December 2011, a total of 228 donors undergoing video assisted minilaparotomy surgery nephrectomy for kidney donation were retrospectively enrolled in the current study. The donors were categorized into a sevoflurane group or desflurane group based on the type of volatile anesthetic used. We collected laboratory data from the patients preoperatively, immediately after the operation, on the first postoperative day and on the third postoperative day. We also compared renal function of the kidney donors after donor nephrectomy by comparing creatinine level and estimated glomerular filtration rate (eGFR). Results: The decrease in renal function after surgery in both groups was the most prominent on the first postoperative day. There were no significant differences between the two groups in postoperative changes of creatinine or eGFR. Conclusion: Sevoflurane and desflurane can be used safely as volatile anesthetics in donors undergoing nephrectomy.
Abstract
Purpose: Although there is no clinical evidence of nephrotoxicity with the volatile anesthetics currently used in general anesthesia, a better agent should be needed in terms of preserving postoperative renal function in living kidney donors who have only single remaining kidney. The purpose of the current retrospective, single-center study was to evaluate and compare renal function of living kidney donors after nephrectomy under either sevoflurane or desflurane anesthesia. Materials and Methods: From January 2006 through December 2011, a total of 228 donors undergoing video assisted minilaparotomy surgery nephrectomy for kidney donation were retrospectively enrolled in the current study. The donors were categorized into a sevoflurane group or desflurane group based on the type of volatile anesthetic used. We collected laboratory data from the patients preoperatively, immediately after the operation, on the first postoperative day and on the third postoperative day. We also compared renal function of the kidney donors after donor nephrectomy by comparing creatinine level and estimated glomerular filtration rate (eGFR). Results: The decrease in renal function after surgery in both groups was the most prominent on the first postoperative day. There were no significant differences between the two groups in postoperative changes of creatinine or eGFR. Conclusion: Sevoflurane and desflurane can be used safely as volatile anesthetics in donors undergoing nephrectomy.
참고문헌 (33)
- Ommen ES, "Medical risks in living kidney donors: absence of proof is not proof of absence", Clin J Am Soc Nephrol, 1, pp.885~895 (2006)
- Ibrahim HN, "Long-term consequences of kidney donation", N Engl J Med, 360, pp.459~469 (2009)
- Gossmann J, "Long-term consequences of live kidney donation follow-up in 93% of living kidney donors in a single transplant center", Am J Transplant, 5, pp.2417~2424 (2005)
- Tent H, "Effects of preexistent hypertension on blood pressure and residual renal function after donor nephrectomy", Transplantation, 93, pp.412~417 (2012)
- Modesti C, "Balanced anestesia versus total intravenous anestesia for kidney transplantation", Minerva Anestesiol, 72, pp.627~635 (2006)
- Teixeira S, "Sevoflurane versus isoflurane: does it matter in renal transplantation?", Transplant Proc, 39, pp.2486~2488 (2007)
- Shah VR, "Combined epidural and general anesthesia for paediatric renal transplantation-a single center experience", Transplant Proc, 40, pp.3451~3454 (2008)
- Bhosale G, "Combined spinal-epidural anesthesia for renal transplantation", Transplant Proc, 40, pp.1122~1124 (2008)
- Campagna JA, "Mechanisms of actions of inhaled anesthetics", N Engl J Med, 348, pp.2110~2124 (2003)
- Young CJ, "Inhalational anesthetics: desflurane and sevoflurane", J Clin Anesth, 7, pp.564~577 (1995)
- 김정민, "Comparison of Emergence Time in Children Undergoing Minor Surgery According to Anesthetic: Desflurane and Sevoflurane", Yonsei Medical Journal, 54(3), pp.732~738 (2013), 연세대학교의과대학[DOI]
- Eun Sung Kim, "The Effects of a Single Bolus of Remifentanil on Corrected QT Interval Change during Sevoflurane Induction", Yonsei Medical Journal, 52(2), pp.333~338 (2011), 연세대학교의과대학
- 장동진, "Effect of Charcoal Filter on the Emergence from Sevoflurane Anesthesia in a Semi-Closed Rebreathing Circuit", Yonsei Medical Journal, 52(4), pp.668~672 (2011), 연세대학교의과대학
- Kobayashi Y, "Serum and urinary inorganic fluoride concentrations after prolonged inhalation of sevoflurane in humans", Anesth Analg, 74, pp.753~757 (1992)
- Keller KA, "Inhalation toxicity study of a haloalkene degradant of sevoflurane, Compound A (PIFE), in Sprague-Dawley rats", Anesthesiology, 83, pp.1220~1232 (1995)
- Smiley RM, "Metabolism of desflurane and isoflurane to fluoride ion in surgical patients", Can J Anaesth, 38, pp.965~968 (1991)
- Goldberg ME, "Sevoflurane versus isoflurane for maintenance of anesthesia: are serum inorganic fluoride ion concentrations of concern?", Anesth Analg, 82, pp.1268~1272 (1996)
- Ebert TJ, "Renal responses to low-flow desflurane, sevoflurane, and propofol in patients", Anesthesiology, 93, pp.1401~1406 (2000)
- Mazze RI, "The safety of sevoflurane in humans", Anesthesiology, 77, pp.1062~1063 (1992)
- Ko JS, "The effects of desflurane and sevoflurane on hepatic and renal functions after right hepatectomy in living donors", Transpl Int, 23, pp.736~744 (2010)
- Kim SI, "Favorable outcomes among recipients of living-donor nephrectomy using video-assisted minilaparotomy", Transplantation, 77, pp.1725~1728 (2004)
- Levey AS, "A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group", Ann Intern Med, 130, pp.461~470 (1999)
- Fang ZX, "Factors affecting production of compound A from the interaction of sevoflurane with Baralyme and soda lime", Anesth Analg, 82, pp.775~781 (1996)
- Cousins MJ, "Methoxyflurane nephrotoxicity. A study of dose response in man", JAMA, 225, pp.1611~1616 (1973)
- Mazze RI, "Inorganic fluoride nephrotoxicity: prolonged enflurane and halothane anesthesia in volunteers", Anesthesiology, 46, pp.265~271 (1977)
- Frink EJ Jr, "Clinical comparison of sevoflurane and isoflurane in healthy patients", Anesth Analg, 74, pp.241~245 (1992)
- Kharasch ED, "Human kidney methoxyflurane and sevoflurane metabolism. Intrarenal fluoride production as a possible mechanism of methoxyflurane nephrotoxicity", Anesthesiology, 82, pp.689~699 (1995)
- Conzen PF, "Low-flow sevoflurane compared with low-flow isoflurane anesthesia in patients with stable renal insufficiency", Anesthesiology, 97, pp.578~584 (2002)
- Bito H, "Effects of low-flow sevoflurane anesthesia on renal function: comparison with high-flow sevoflurane anesthesia and low-flow isoflurane anesthesia", Anesthesiology, 86, pp.1231~1237 (1997)
- Vats HS, "Early postnephrectomy donor renal function: laparoscopic versus open procedure", Transplantation, 79, pp.609~612 (2005)
- Bito H, "Closed-circuit anesthesia with sevoflurane in humans. Effects on renal and hepatic function and concentrations of breakdown products with soda lime in the circuit", Anesthesiology, 80, pp.71~76 (1994)
- Moore E, "Biomarkers of acute kidney injury in anesthesia, intensive care and major surgery: from the bench to clinical research to clinical practice", Minerva Anestesiol, 76, pp.425~440 (2010)
- McIlroy DR, "Biomarkers of acute kidney injury: an evolving domain", Anesthesiology, 112, pp.998~1004 (2010)
