| English |
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| Title | Sevoflurane Anesthesia for Coronary Artery Bypass Graft Surgery Does Not Aggravate Renal Tubular Function in Patients with Preexisting Renal Dysfunction |
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| Subtitle | |
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| Authors | Hiroshi Sakamoto |
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| Authors(kana) | |
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| Organization | Staff in Anesthesia, Cardiovascular Center Hokkaido Ohno Hospital |
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| Journal | Circulation Control |
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| Volume | 23 |
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| Number | 3 |
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| Page | 293-306 |
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| Year/Month | 2002/ |
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| Article | Original article |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | Background：Sevoflurane use is restricted because of potential fluoride induced renal problems. This study was designed to evaluate sevoflurane renal toxicity for coronary artery bypass graft （CABG） surgery in patients with preexisting renal dysfunction. Methods ： After obtaining written approval, 24 patients with renal dysfunction （creatinine clearance （Ccr） <55 mL（min-1） and 62 patients with normal renal function （Ccr≧ 55 mL（min-1） undergoing CABG surgery were enrolled. The patients with renal dysfunction were anesthetized with fentanyl 20μg・kg-1 followed either sevoflurane 0.5 MAC or isoflurane 0.5 MAC. The patients with normal renal function were anesthetized with one of the same methods as patients with renal dysfunction, or sevoflurane 1.0 MAC or isoflurane 1.0 MAC. During cardiopulmonary bypass, volatile anesthetics were administered through a membrane oxygenator. Serum and urinary inorganic fluoride levels （SF-, UF-）, blood urea nitrogen （BUN） and creatinine （Cr） were measured and Ccr, fractional clearance of β2microglobulin, urinary β2microglobulin/ urinary creatinine and urinary N-acetyl-β-glucosidase/ urinary creatinine were calculated. Results ： Levels of SF- during sevoflurane anesthesia were significantly higher than other anesthetic methods. The highest SF levels were 48.4 μM and 24.2μM in the patients with normal and impaired renal function, respectively. Changes of BUN, Cr, clearances and other indices were not different among the groups. Conclusions ： Sevoflurane 0.5 MAC in patients with renal dysfunction did not aggravate preexisting renal dysfunction postoperatively. Sevoflurane 0.5 MAC can be safely used for CABG surgery in patients with impaired renal function. |
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| Practice | Basic medicine |
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| Keywords | sevoflurane, isoflurane, fluoride, cardiac surgery, kidney |
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