Liver and renal function after volatile induction and maintenance of anesthesia (VIMA) with sevoflurane versus TIVA with sufentanil-midazolam for CABG surgery.

We compared liver and renal function after volatile induction and maintenance of anesthesia (VIMA) with sevoflurane and minimal dose sufentanil versus total intravenous anesthesia (TIVA) with moderate dose of midazolam and sufentanil in patients undergoing CABG surgery. Eighty nine patients were studied retrospectively after VIMA (44 patients) or after TIVA (45 patients). Liver and renal function were measured before (T0), then 1 (T1), 2 (T2), 5 (T3) days and 6 weeks (T4) after the operation. Serum levels of aspartate aminotransferase (ASAT) and lactate dehydrogenase (LDH) increased in both groups at T1, T2 and T3 and the highest levels were at T1. Levels of total bilirubin (TBil) increased at T1 only in the TIVA group. Levels of g-glutamyl transpeptidase (GGT) and alanine aminotransferase (ALAT), increased in both groups at T3. Serum levels of creatinine (Cr) were high in both groups on T1 and T2. Blood urea nitrogen (BUN) was high in both group at T2, and T3 with the peak levels in T2. Six weeks after the operation all liver and renal functions were normal in both groups. We concluded that VIMA with sevoflurane during cardiac surgery has no untoward effects on liver or renal functions. The transient reversible elevation was comparable in the VIMA and TIVA groups which was most probably due to the effect of the operation itself.