Slaven G M, Walker R J, Zacharias M, Fawcett J P, Hodgson B F
Department of Anaesthesia and Intensive Care, Dunedin School of Medicine, New Zealand.
Aust N Z J Med. 1998 Dec;28(6):772-6. doi: 10.1111/j.1445-5994.1998.tb01552.x.
Anaesthesia and surgery alter renal function. Inhibition of prostaglandin synthesis by non-steroidal anti-inflammatory drugs (NSAIDs) administered with anaesthesia may further compromise renal function.
To study the effects of tenoxicam (NSAID) administered immediately prior to anaesthesia on renal function in normal individuals undergoing routine surgery.
A randomised single blind placebo controlled study comparing tenoxicam (40 mg intravenously) with placebo was carried out in 20 healthy (ASA I) patients undergoing lower spinal surgery. Glomerular filtration rate (GFR) was determined by creatinine clearance and renal tubular function measured as osmolar and free water clearance.
GFR fell by 60% at the end of surgery but returned to pre-operative values by six hours post-operatively. There was no difference between placebo or tenoxicam with regard to changes in GFR. Tubular function was not altered by tenoxicam.
Current clinical practice of using NSAIDs for post-operative analgesia in low risk individuals appears to have no adverse effects on renal function.
麻醉和手术会改变肾功能。麻醉时使用非甾体抗炎药(NSAIDs)抑制前列腺素合成可能会进一步损害肾功能。
研究在接受常规手术的正常个体中,麻醉前即刻给予替诺昔康(一种NSAIDs)对肾功能的影响。
对20例接受下脊柱手术的健康(ASA I级)患者进行了一项随机单盲安慰剂对照研究,比较替诺昔康(静脉注射40毫克)与安慰剂的效果。通过肌酐清除率测定肾小球滤过率(GFR),并以渗透清除率和自由水清除率来衡量肾小管功能。
手术结束时GFR下降了60%,但术后6小时恢复到术前值。在GFR变化方面,安慰剂组和替诺昔康组之间没有差异。替诺昔康未改变肾小管功能。
目前在低风险个体中使用NSAIDs进行术后镇痛的临床实践似乎对肾功能没有不良影响。