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肾切除术患者在七氟醚或地氟醚麻醉下的肾功能。

Kidney function in living donors undergoing nephrectomy by sevoflurane or desflurane anesthesia.

机构信息

Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea.

出版信息

Yonsei Med J. 2013 Sep;54(5):1266-72. doi: 10.3349/ymj.2013.54.5.1266.

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.

摘要

目的

尽管目前在全身麻醉中使用的挥发性麻醉剂在临床上没有肾毒性的证据,但对于只有一个剩余肾脏的活体供肾者,为了保护术后肾功能,仍需要更好的麻醉剂。本回顾性单中心研究的目的是评估和比较使用七氟醚或地氟醚麻醉行腹腔镜辅助小切口肾切除术的活体供肾者术后的肾功能。

材料与方法

2006 年 1 月至 2011 年 12 月,共有 228 例接受视频辅助小切口腹腔镜肾切除术的供者纳入本研究。根据使用的挥发性麻醉剂的类型,供者分为七氟醚组或地氟醚组。我们收集了患者术前、术后即刻、术后第 1 天和第 3 天的实验室数据。我们还通过比较肌酐水平和估算肾小球滤过率(eGFR)来比较肾切除术后供者的肾功能。

结果

两组患者术后肾功能下降最明显的是术后第 1 天。两组患者术后肌酐或 eGFR 的变化无显著差异。

结论

七氟醚和地氟醚可安全地用作行肾切除术的供者的挥发性麻醉剂。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d701/3743197/1aabaeedfabe/ymj-54-1266-g001.jpg

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