Masuda A, Asahi T, Sakamaki M, Nakamaru K, Hirota K, Ito Y
Department of Anesthesiology, Faculty of Medicine, Toyama Medical and Pharmaceutical University, Sugitani, Japan.
Anesth Analg. 1997 Jul;85(1):144-8. doi: 10.1097/00000539-199707000-00026.
We compared the effect of propofol with that of sevoflurane anesthesia on uric acid (UA) excretion in ASA physical status I and II patients with normal renal function. A propofol group (n = 11) received propofol-nitrous oxide-fentanyl after induction of anesthesia by propofol, while a sevoflurane group (n = 12) received sevoflurane-nitrous oxide-fentanyl after induction of anesthesia by thiamylal. UA, creatinine (Cr), and urea nitrogen concentrations in serum and urine were measured before induction of anesthesia, 1, 2, and 3 h after induction, and on Postoperative Day 1. N-acetyl-beta-D-glucosaminidase, beta2-microglobulin concentrations, and pH in urine were also examined. Plasma clearance of UA (CUA) and Cr (CCr) were calculated. The hourly concentration and excretion of urine UA were significantly higher than those of the sevoflurane group (P < 0.01). Significant correlations were noted between the hourly urine volume and UA concentration (r = 0.58, P < 0.01 for the propofol group; r = 0.51, P < 0.01 for the sevoflurane group). The CUA of the propofol group was significantly higher than that of the sevoflurane group (22.9 +/- 10.6 vs 5.9 +/- 3.4 mL/min, mean +/- SD, P < 0.05). There were no significant differences in other renal variables between the two groups. The present study demonstrated that the UA excretion increased during propofol anesthesia, while it remained stable during sevoflurane anesthesia.
我们比较了丙泊酚与七氟醚麻醉对肾功能正常的美国麻醉医师协会(ASA)身体状况I级和II级患者尿酸(UA)排泄的影响。丙泊酚组(n = 11)在丙泊酚诱导麻醉后接受丙泊酚-氧化亚氮-芬太尼,而七氟醚组(n = 12)在硫喷妥钠诱导麻醉后接受七氟醚-氧化亚氮-芬太尼。在麻醉诱导前、诱导后1、2和3小时以及术后第1天测量血清和尿液中的UA、肌酐(Cr)和尿素氮浓度。还检测了尿液中的N-乙酰-β-D-氨基葡萄糖苷酶、β2-微球蛋白浓度和pH值。计算了UA(CUA)和Cr(CCr)的血浆清除率。丙泊酚组每小时尿液UA浓度和排泄量显著高于七氟醚组(P < 0.01)。每小时尿量与UA浓度之间存在显著相关性(丙泊酚组r = 0.58,P < 0.01;七氟醚组r = 0.51,P < 0.01)。丙泊酚组的CUA显著高于七氟醚组(22.9 +/- 10.6 vs 5.9 +/- 3.4 mL/min,平均值 +/- 标准差,P < 0.05)。两组之间的其他肾脏变量无显著差异。本研究表明,丙泊酚麻醉期间UA排泄增加,而七氟醚麻醉期间UA排泄保持稳定。