Saricaoğlu Fatma, Akinci Seda Banu, Oç Bahar, Kanbak Meral, Akbulut Birkan, Celebioglu Bilge
Hacettepe University, Department of Anesthesia and Reanimation, Ankara, Turkey.
Middle East J Anaesthesiol. 2006 Jun;18(5):955-64.
Renal insufficiency after cardiac surgery is associated with increased mortality, morbidity, and length of stay in the intensive care unit. We investigated the effect of isoflurane, halothane, sevoflurane and propofol anesthesia on perioperative renal function following elective coronary artery surgery. The medical records of 224 patients, in the Hacettepe University Medical Faculty Hospital who had undergone cardiac surgery in one year, were retrospectively reviewed. 65 (29%) patients received isoflurane, 68 (30%) patients received halothane, 64 (29%) patients received sevoflurane, and 27 (12%) patients received propofol infusion as part of maintenance anesthesia for coronary artery bypass surgery. Patient characteristics (age, sex, preoperative ejection fraction), operative data (duration of CPB, duration of operation, number of distal anastomoses, usage of diuretic, intraoperative crystalloid and blood transfusion), intraoperative urinary output, preoperative and postoperative (6th hours and 24th hours) BUN and plasma creatinine levels, were not statistically significant between and within groups. Intraoperative inotropic agent (dopamine) was used in 8 (12.3%) patients in the isoflurane group, in 10 (14.7%) patients in the halothane group, in 11 (17.2%) patients in sevoflurane group and in 9 (33.3%) patients in the propofol group. Postoperatively fluid and blood transfusion, postoperative drainage, urinary output, diuretic usage were smiliar between the four groups (p>0,05). Inotropic agent was used in 8 (12.3%) patients in the isoflurane group, in 9 (13.2%) patients in the halothane group, in 16 (25%) patients in the sevoflurane group and in 7 (25.9%) patients in the propofol group. It is concluded that, halothane, isoflurane, sevoflurane and propofol infusion anesthesia as part of anesthesia maintenance for elective coronary artery bypass surgery does not affect early postoperative renal functions.
心脏手术后的肾功能不全与死亡率增加、发病率升高以及重症监护病房住院时间延长相关。我们研究了异氟烷、氟烷、七氟烷和丙泊酚麻醉对择期冠状动脉手术后围手术期肾功能的影响。回顾性分析了在哈杰泰佩大学医学院医院一年内接受心脏手术的224例患者的病历。65例（29%）患者接受异氟烷麻醉，68例（30%）患者接受氟烷麻醉，64例（29%）患者接受七氟烷麻醉，27例（12%）患者接受丙泊酚输注作为冠状动脉搭桥手术维持麻醉的一部分。患者特征（年龄、性别、术前射血分数）、手术数据（体外循环时间、手术时间、远端吻合数量、利尿剂使用情况、术中晶体液和输血情况）、术中尿量、术前及术后（第6小时和第24小时）血尿素氮和血浆肌酐水平在组间和组内均无统计学差异。异氟烷组8例（12.3%）患者术中使用了血管活性药物（多巴胺），氟烷组10例（14.7%）患者，七氟烷组11例（17.2%）患者，丙泊酚组9例（33.3%）患者。术后液体和输血、术后引流量、尿量、利尿剂使用情况在四组之间相似（p>0.05）。异氟烷组8例（12.3%）患者使用了血管活性药物，氟烷组9例（13.2%）患者，七氟烷组16例（25%）患者，丙泊酚组7例（25.9%）患者。结论是，作为择期冠状动脉搭桥手术麻醉维持一部分的氟烷、异氟烷、七氟烷和丙泊酚输注麻醉不影响术后早期肾功能。
