Abdulkadir İSKENDER, HATİCE AYSEL ALTAN, Emine ÖZYUVACI, Özyiğit Özden ERTUĞRUL

Desfluran ve sevofluran anestezisinin böbrek fonksiyonlarına etkisi

Bu çalışmada elektif jinekolojik operasyon geçiren 40 hastada, sevofluran ve desfluran anestezisinin böbrek fonksiyonları üzerine etkilerim araştırdık. Her hastaya operasyondan bir gün önce ve operasyon sonrası 3 gün süre ile yapılacak testler anlatılarak, serum ve idrar biyokimyaları incelendi. Tiyopental sodyum, atrakuryum vefentanil ile anestezi indüksiyonu yapılıp, desfluran (Grup D) ve sevofluran (Grup S) ile genel anestezi idamesine geçildi. Operasyon sırasında hemodinamik parametreler, operasyon öncesi ve sonrası L, 2. ve 3. günlerde böbrek fonksiyon testleri incelendi. Operasyon öncesi, serumda BUN (kan-üre nitrojeni), kreatinin, protein, glukoz, albumin, ürik asit, kreatinin klirensi, 24 saatte toplanan idrarda protein miktarı, albumin miktarı, glukoz, ürik asit ve kreatinin değerleri ölçüldü ve bu ölçümler operasyondan sonra L, 2., 3. günlerde tekrar edildi. Ölçülen serum ve idrar değerleri preoperatif ve postoperatif dönemde karşılaştırıldıklarında gruplar arasında anlamlı bir fark görülmedi. Sadece serumda kreatinin grup D'de 3. günde gruplar arası karşılaştırmada anlamlı olarak yükseldi (p

Anahtar Kelimeler:

Serum, Böbrek, İdrar, Anestezikler, inhalasyon

The effects of desflurane and sevoflurane anesthesia on renal function

In this study we evaluated the effects of sevoflurane and desflurane anesthesia on renal functions in 40 cases who under-went elective gynecologic operations. Laboratory tests were performed the day before and 3 days after the operation and were explained to all the patients. Pati-ents were given thiopental, atracurium and fentanyl during induction period and maintenance was carried out with either desflurane (group D) or sevoflurane (group S). Hemodynamic parameters were monitored throughout the operation. Renal functions were evaluated preoperatively and on the first, second and third postoperative days. Serum BUN (Blood-urea nitrogen), creatinine, protein, glucose, albumin, uric acid, creatinine clearence and protein, albumin, glucose, uric acid and creatinine in urine collected in 24 hours were measured on the first, second and third postoperative days. There were no significant differences in serum and urinary test results between the groups pre and postoperatively. Only blood creatinine values increased significantly on the third day in group D (p<0,05). In group S serum glucose and creatinine values were statistically different on the 2nd postoperative day (p<0,05). Serum uric acid were significantly higher on the 1st postoperative day in group D. Serum BUN values were significantly higher on the 2nd and 3rd postoperative days in group S and serum albumin values were significantly lower in both groups on the 1st, 2nd and 3rd postoperative days. No significant differences have been noted in urine parameters between the groups. However, urine uric acid and glucose values in both groups were higher on the first postoperative day. Urine protein values were higher in both groups on the 1st, 2nd and 3rd postoperative days. Albumin values were higher in group S on the 1st postoperative day and urine creatinine values increased in both groups on the 3rd postoperative day (p<0,05).It is not possible to make a definite statement about the renal toxicity of inhalation anesthesia without performing some specific tests and renal biopsy. However, We conclude that both agents could be used safely based on our current data.

Keywords:

Serum, Kidney, Urine, Anesthetics, Inhalation,

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