Fernandes Adriano, Ettinger João, Amaral Fabiano, Ramalho Maria José, Alves Rodrigo, Módolo Norma Sueli Pinheiro
Department of Anesthesiology, São Rafael Hospital, Salvador, BA, Brazil.
Department of Surgery, São Rafael Hospital, Salvador, BA, Brazil.
Clinics (Sao Paulo). 2014 Dec;69(10):655-9. doi: 10.6061/clinics/2014(10)01.
Video laparoscopic bariatric surgery is the preferred surgical technique for treating morbid obesity. However, pneumoperitoneum can pose risks to the kidneys by causing a decrease in renal blood flow. Furthermore, as in other surgical procedures, laparoscopic bariatric surgery triggers an acute inflammatory response. Neutrophil gelatinase-associated lipocalin is an early and accurate biomarker of renal injury, as well as of the inflammatory response. Anesthetic drugs could offer some protection for the kidneys and could attenuate the acute inflammatory response from surgical trauma. The objective of this study was to compare the effects of two types of anesthetics, propofol and sevoflurane, on the serum levels of neutrophil gelatinase-associated lipocalin during the perioperative period in laparoscopic bariatric surgery.
Sixty-four patients scheduled for laparoscopic bariatric surgery were randomized into two anesthesia groups and were administered either total intravenous anesthesia (propofol) or inhalation anesthesia (sevoflurane). In the perioperative period, blood samples were collected at three time points (before anesthesia, 6 hours after pneumoperitoneum and 24 hours after pneumoperitoneum) and urine output was measured for 24 hours. Acute kidney injuries were evaluated by examining both the clinical and laboratory parameters during the postoperative period. The differences between the groups were compared using non-parametric tests. ReBEC (http://www.ensaiosclinicos.gov.br/rg/recruiting/): RBR-8wt2fy
None of the patients developed an acute kidney injury during the study and no significant differences were found between the serum neutrophil gelatinase-associated lipocalin levels of the groups during the perioperative period.
The choice of anesthetic drug, either propofol or sevoflurane, did not affect the serum levels of neutrophil gelatinase-associated lipocalin during the perioperative period in laparoscopic bariatric surgery.
视频腹腔镜减肥手术是治疗病态肥胖的首选手术技术。然而，气腹可通过导致肾血流量减少对肾脏构成风险。此外，与其他外科手术一样，腹腔镜减肥手术会引发急性炎症反应。中性粒细胞明胶酶相关脂质运载蛋白是肾损伤以及炎症反应的一种早期且准确的生物标志物。麻醉药物可为肾脏提供一定保护，并可减轻手术创伤引起的急性炎症反应。本研究的目的是比较两种麻醉剂丙泊酚和七氟醚在腹腔镜减肥手术围手术期对中性粒细胞明胶酶相关脂质运载蛋白血清水平的影响。
64例计划行腹腔镜减肥手术的患者被随机分为两组麻醉组，分别给予全静脉麻醉（丙泊酚）或吸入麻醉（七氟醚）。在围手术期，于三个时间点（麻醉前、气腹后6小时和气腹后24小时）采集血样，并测量24小时尿量。通过检查术后的临床和实验室参数评估急性肾损伤。使用非参数检验比较组间差异。ReBEC（http://www.ensaiosclinicos.gov.br/rg/recruiting/）：RBR - 8wt2fy
研究期间无患者发生急性肾损伤，围手术期两组血清中性粒细胞明胶酶相关脂质运载蛋白水平无显著差异。
在腹腔镜减肥手术围手术期，丙泊酚或七氟醚这两种麻醉药物的选择并未影响中性粒细胞明胶酶相关脂质运载蛋白的血清水平。
