Comparison of Renal Function during Sevoflurane versus Total Intravenous Propofol Anaesthesia in Patients undergoing Abdominal Surgeries: A Randomised Controlled Trial

Introduction:For practically all surgeries, inhalational anaesthesia has been the most widely used way to maintain general anaesthesia.Inhalational anaesthesia has a more severe effect on the oxygenation and circulation of the kidneys than propofol does.Over the past thirty years, many studies have examined the impact of sevoflurane on kidney function following surgery, even if the amount of evidence remains incompletely studied.Compared to propofol, we hypothesized sevoflurane to cause a decrease in the excretion of salt and water in the urine.Aims/ objective: To compare the effect of sevoflurane and propofol total intravenous anaesthesia on renal function peri-operatively in patients undergoing abdominal surgeries in tertiary care centre of eastern India. Materials and Method:33 patients in Group S planned for elective abdominal surgery were given 1-2% sevoflurane in a mixture of oxygen and air to maintain anaesthesia following the delivery of pre-anaesthetic medications.To maintain anaesthesia, 32 patients in group P received intravenous rote propofol at a dosage of 2-4 mg/kg/h.The primary outcome indicator during surgery was the amount of urine produced.Secondary outcome measures were electrolyte excretion, plasma osmolality, serum creatinine, and serum electrolytes.Results: Patients under sevoflurane anaesthesia had a significantly greater fall in urine output during surgery (1.14 to 0.56 ml/kg/hr) than those under propofol anaesthesia (1.09 to 0.946 ml/kg/hr) (p<0.05).Additionally, patients under sevoflurane anaesthesia excreted less sodium fractionally than those under propofol anaesthesia (p<0.05).Compared to patients under propofol anaesthesia, those under sevoflurane anaesthesia had a considerably higher serum NGAL level (110.38 to 239.21 ng/ml), indicating renal damage (p<0.0001).Patients under sevoflurane anaesthesia had slightly elevated serum levels of potassium and plasma osmolality. Conclusion:When propofol anaesthesia was used instead of sevoflurane, patients' renal function was more intact.The reduced increase in NGAL level in the propofol group after surgery served as evidence for this.