A. Kadir BUT, MAHMUT DURMUŞ, Ahmet KÖROĞLU, Aytaç YÜCEL, Hacer ÜLGER, M. Özcan ERSOY

Yaşlı olgularda sevofluran ve propofolün karaciğer ve böbrek fonksiyonlarına etkisi

Bu çalışmada 65 yaş üzerindeki olgularda sevofluran ve propofolün karaciğer ve böbrek fonksiyonları üzerine olan etkilerini karşılaştırmayı amaçladık. ASA l-ll grubunda, 65 yaş üzerinde, elektif cerrahi uygulanacak 46 olgu çalışmaya alındı. Anestezi indüksiyonu sevofluran grubunda (Grup S, n=23) %66 N2O içinde %7 sevofluran ile sağlanırken, propofol grubunda (Grup P, n=23) IV 1-2 mg $kg^-1$ propofol ile yaklaşık 30 sn de gerçekleştirildi. Anestezi idamesi Grup S'de %l-4 sevofluran ve %66 N2O, Grup P'de ise 2-10 mg $kg^-1$ $st^-1$ propofol ve %66 N2O ile sağlandı. Çalışmaya alınan tüm olgulardan, total bilirubin (T.bil), aspartat aminotransferaz (AST), alanin aminotransferaz (ALT), g-glutamil transpeptidaz (GGT), laktat dehidrogenaz (LDH), alkalen fosfataz (ALP), kreatinin (Krt) ve kan üre nitrojeni (BUN) ölçümleri için indüksiyondan hemen önce (preoperatif), postoperatif l, 3, 5-7 ve 14. günlerde kan alındı. Aynı dönemlerde kreatinin klirensi (K.Klr) hesaplandı, idrarda protein ve glukozun kalitatif analizleri yapıldı. Grup S'de; preoperatif değere göre AST ve GGT değerleri postoperatif tüm periyotlarda, ALT ve LDH postoperatif l ve 5-7. günlerde, ALP ve K.Klr postoperatif 3. günde anlamlı olarak daha yüksek bulundu (p

Anahtar Kelimeler:

Eterler, Yaşlı, Anestezikler, inhalasyon, Karaciğer fonksiyon testleri, Böbrek fonksiyon testleri

The effects of sevoflurane and propofol on hepatic and renal fumctions in elderly patients

In this study, we aimed to compare the effects of sevoflurane and propofol on hepatic and renal f unctions in patients more than 65 years of age. 46 patients, ASA physical status I-II, more than 65 years of age, undergoing elective surgery were taken into the study. Anaesthesia was induced with 66% N2O and 7% sevoflurane in the group S (n=23) and iv. 1-2 mg $kg^-1$ propofol approximately within 30 seconds in the group P (n=23). Anesthesia was maintained with 1-4% sevoflurane and 66% N2O in group S,2 -10 m $kg^-1$ $hr^-1$ propofol and 66% N2O in group P. Blood sample was taken from all patients preoperatively and postoperative 1, 3, 5-7 and 14. days to measure the total bilirubine (T.Bil.), aspartate aminotransferase (AST), g-glutamyl transferase (GGT), lactate dehydrogenase (LDH), alkalane phosphatase (ALP), creatinine (ere) and blood urea nitrogen (BUN). At the same time periods, creatinine clearences (K.Klr) were calculated, and protein and glucose qualitative analyses were done in urine. In Group S, AST and GGT at all postoperative periods, ALT and LDH in postoperatively 1 and 5-7th days, ALP and K.Klr in postoperatively 3rd day were measured significantly higher than preoperative basal values. In Group P, T.bil in postoperati-ve 1st day, AST in postoperative 14th day, ALT and ALP at all postoperative periods, LDH in postoperative 1st and 3rd days were measured significantly higher than preoperative basal values. As a result; we concluded that sevoflurane and propofol anesthesia in ASA I-II elderly cases undergoing elective surgery, renal functions were preserved for both of the groups, but although there was no statistically significant difference between two groups, minimal transient hepatic dysfunctions were signifantly more in sevoflurane group.

Keywords:

Ethers, Aged, Anesthetics, Inhalation, Liver Function Tests, Kidney Function Tests,

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