Li Mingjuan, You Wenli, Chi Xiaosa, Nie Maomao, Xie Anmu
Department of Anaesthesiology, The Affiliated Hospital of Qingdao University, Qingdao, China.
Department of Proctology, The Affiliated Hospital of Qingdao University, Qingdao, China.
J Coll Physicians Surg Pak. 2025 Apr;35(4):480-485. doi: 10.29271/jcpsp.2025.04.480.
Sevoflurane has been suggested to lower the incidence of acute kidney injury (AKI) after heart surgery compared to intravenous anaesthetics. However, recent studies indicated opposite results. Therefore, this meta-analysis was conducted on randomised controlled trials (RCTs) to determine if sevoflurane decreases the risk of AKI compared to propofol. Relevant RCTs were identified from PubMed, EMBASE databases, and reference lists of reviews and related articles till June 6, 2023. Review Manager was used for statistical analysis. In this study, 10 RCTs were included. Compared with propofol, sevoflurane increased the incidence of AKI (odds ratio [OR], 2.74; 95% confidence interval [CI], 1.62-4.65; p = 0.0002; I2 = 13%) and prolonged the length of intensive care unit (standard mean difference [SMD], 0.29; 95% CI, 0.06-0.53; p = 0.01; I2 = 0%) and hospital stays (mean difference [MD], 1.62; 95% CI, 0.59-2.64; p = 0.002; I2 = 0%). Based on current evidence, sevoflurane was linked to an increased risk of perioperative AKI compared to propofol. To verify the results, more high-quality RCTs are necessary. Key Words: Acute kidney injury, Sevoflurane anaesthesia, Propofol anaesthesia, Perioperative renal complications, Serum creatinine.
与静脉麻醉剂相比，七氟醚被认为可降低心脏手术后急性肾损伤（AKI）的发生率。然而，近期研究显示了相反的结果。因此，本荟萃分析针对随机对照试验（RCT）进行，以确定与丙泊酚相比，七氟醚是否能降低AKI风险。通过检索PubMed、EMBASE数据库以及综述和相关文章的参考文献列表，截至2023年6月6日，确定了相关的RCT。使用Review Manager进行统计分析。本研究纳入了10项RCT。与丙泊酚相比，七氟醚增加了AKI的发生率（比值比[OR]，2.74；95%置信区间[CI]，1.62 - 4.65；p = 0.0002；I² = 13%），延长了重症监护病房住院时间（标准均差[SMD]，0.29；95% CI，0.06 - 0.53；p = 0.01；I² = 0%）以及住院时间（均值差[MD]，1.62；95% CI，0.59 - 2.64；p = 0.002；I² = 0%）。基于目前的证据，与丙泊酚相比，七氟醚与围手术期AKI风险增加有关。为验证结果，需要更多高质量的RCT。关键词：急性肾损伤；七氟醚麻醉；丙泊酚麻醉；围手术期肾脏并发症；血清肌酐
