Sevoflurane has no adverse effects on renal function in cirrhotic patients: a comparison with propofol

Acta Anaesthesiol Scand. 2013 Aug;57(7):896-902. doi: 10.1111/aas.12085. Epub 2013 Mar 26.

Abstract

Background: Cirrhotic patients are prone to developing renal dysfunction after anaesthesia and surgery. However, no consensus has been reached whether sevoflurane could have adverse effects on renal function in cirrhotic patients. We hypothesised that the use of sevoflurane for general anaesthesia would lead to post-operative renal dysfunction in cirrhotic patients undergoing liver resection.

Methods: A total of 200 patients undergoing liver resection were randomly assigned to a propofol or sevoflurane group. The influence of sevoflurane or propofol on renal function was evaluated by the maximal change, the difference between the pre-operative baseline and the highest values of serum creatinine and blood urea nitrogen measured at day 1, 3 and 6 post-operatively.

Results: The maximal change in serum creatinine after liver resection was -4.52 (5.78) μmol/l and -3.37 (7.34) μmol/l with P = 0.398, and that in blood urea nitrogen was 0.41 (1.49) mmol/l and 0.93 (1.54) mmol/l with P = 0.098 between the sevoflurane group (n = 52) and the propofol group (n = 50), respectively.

Conclusions: Sevoflurane does not seem to impair post-operative renal function in cirrhotic patients undergoing liver resection.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anesthetics, Inhalation / adverse effects*
  • Anesthetics, Inhalation / pharmacology
  • Anesthetics, Intravenous / adverse effects*
  • Anesthetics, Intravenous / pharmacology
  • Blood Urea Nitrogen
  • Creatinine / blood
  • Diuresis / drug effects
  • Female
  • Fluid Therapy
  • Hepatectomy*
  • Humans
  • Kidney / drug effects*
  • Kidney / physiopathology
  • Kidney Diseases / blood
  • Kidney Diseases / chemically induced
  • Kidney Diseases / etiology
  • Kidney Diseases / physiopathology
  • Length of Stay / statistics & numerical data
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / physiopathology
  • Liver Cirrhosis / surgery*
  • Male
  • Methyl Ethers / adverse effects*
  • Methyl Ethers / pharmacology
  • Middle Aged
  • Postoperative Complications / blood
  • Postoperative Complications / etiology
  • Postoperative Complications / physiopathology
  • Propofol / adverse effects*
  • Propofol / pharmacology
  • Sevoflurane

Substances

  • Anesthetics, Inhalation
  • Anesthetics, Intravenous
  • Methyl Ethers
  • Sevoflurane
  • Creatinine
  • Propofol