SEVTAP HEKİMOĞLU ŞAHİN, İnci PAKSOY, Özer Surhan ÇINAR, Sibel OBA, Ayşe HANCI

Orta süreli ameliyatlarda sevofluran ve desfluranla sağlanan düşük akım anestezinin böbrek ve karaciğer işlevlerine etkisi

Amaç: Orta süreli ameliyatlarda sevofluran ve desfluranla sağlanan düşük akım anestezinin böbrek ve karaciğer işlevlerine etkilerinin karşılaştırılması amaçlandı. Yöntem: Elektif disk hernisi ameliyatı planlanan, ameliyat süresi 120-240 dakika arasında olan, ASA I- II grubu, 25- 70 yaş aralığında 45 olgu çalışmaya alındı. Ameliyattan önce ve postoperatif ilk üç gün serumda üre, kreatinin, AUT, AST, LDH ve idrarda 24 saatlik glukoz, protein ve kreatinin ölçümleri yapıldı. Taze gaz akımı ilk on dakika 5 L dk~' daha sonra ise 1 L dk"ya düşürüldü, ilk on dakika Grup S'de (n—22) sevofluran %2-2.5, Grup D'de (n=23) desfluran %3-4, idamede ise sırasıyla %3-3.5 ve %4-5.5 konsantrasyonlarda %50 O2-hava karışımı içinde uygulandı. Bulgular: Postoperatif tüm zamanlarda Grup S ve D'de serum üre, kreatinin, ALT, AST ve LDH ve idrar glukoz, protein ve kreatinin değerleri preoperatif döneme göre yüksek idi (p

Anahtar Kelimeler:

Anestezi, Böbrek, Karaciğer, Ameliyat sonrası dönem

The effect of the low-flow anesthesia provided by sevoflurane versus desflurane on the renal and hepatic functions during moderate-duration opaerations

Objective: This study was aimed to compare the effect of low-flow anesthesia provided by sevoflurane versus desflurane on the renal and hepatic functions during moderate duration operations. Method: 45 patients (25-70 years) scheduled for elective disc operations with an operation time of 120-240 min were studied. Serum urea, creatinine, ALT, AST, LDH were measured before the operation and postoperative three days, and 24 hours of glucose, protein, creatinine levels were obtained in the urine. Fresh gas flow was initiated with 5 L min'1 for the first 10 minutes and then decreased to 1 L min'. Initial concentrations were 2-2.5% for sevoflurane in Group S and 3-3.5% for desflurane in group D. Maintenance was provided with sevoflurane 4-5.5% and desflurane 3-4% in 50% oxygen-air. Results: The postoperative values of serum urea, creatinine, ALT, AST, LDH and urine glucose, protein, creatinine were higher than preoperative values in both groups. In group D serum urea at 24, 48th hours, creatinine at 24, 48, 72nd hours, ALT at 48, 72nd hours, and urine glucose at 24, 48, 72nd hours were higher than group S (p<0.05). Conclusion: We observed no clinical differences in the effect of the low-flow anesthesia provided by sevoflurane versus desflurane on the renal and hepatic functions during moderate-duration operations.

Keywords:

Anesthesia, Kidney, Liver, Postoperative Period,

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