Key result
Propofol was superior to sevoflurane in reducing renal ischemia and oxidative stress, reflected by lower serum creatinine and proinflammatory cytokines.
Why the study?
Does propofol total intravenous anesthesia reduce renal reperfusion injury compared to sevoflurane in patients undergoing suprarenal infracoeliac aortic surgery?
RCT (n=30)
Does propofol total intravenous anesthesia reduce renal reperfusion injury compared to sevoflurane in patients undergoing suprarenal infracoeliac aortic surgery?
p-value: p=<0.001
Propofol total intravenous anesthesia may offer superior renal protection and reduced oxidative stress compared to sevoflurane during suprarenal aortic surgery.
May suggest renal benefit with propofol in aortic surgery; hypothesis-generating and should not yet change practice.
Introduction This study was designed to assess and compare the effect of propofol total intravenous anesthesia as against sevoflurane volatile induction and maintenance of anesthesia during suprarenal aortic clamping as part of renal protection strategies utilizing serum creatinine and proinflammatory cytokines: tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) as stress biomarkers. Patients and methods A total of 30 patients scheduled for major elective abdominal suprarenal infracoeliac aortic surgery were included. Fifteen of them received propofol total intravenous anesthesia (group P) and the other 15 received sevoflurane volatile induction and maintenance of anesthesia (group S). Serum creatinine level and plasma TNF-α and IL-1β were measured at the following intervals: before the initiation of surgery (T0), 15 min after reperfusion (T1), and 24 h (T2), 48 h (T3), and 72 h (T4) after end of surgery. Results Group S demonstrated higher levels of serum creatinine, plasma TNF-α, and IL1-β following the release of cross-clamp than group P. The highest level of serum creatinine was observed at T2 and then values tended to decline afterward in both groups (P < 0.001), whereas a significant increase over time for both plasma TNF-α and IL-1β was observed in the two studied groups (P < 0.001); the highest levels were detected at T4. Conclusion In this surgical setting, propofol is superior to sevoflurane in reducing renal ischemia and oxidative stress as reflected by lower values of serum creatinine and plasma proinflammatory cytokines: TNF-α and IL-1β.
No takes yet. Share an insight, caveat, or question.
Elzayyat et al. (2014) conducted an RCT in Major elective abdominal suprarenal infracoeliac aortic surgery (n=30). Propofol total intravenous anesthesia vs. Sevoflurane volatile induction and maintenance of anesthesia was evaluated on Serum creatinine level and plasma TNF-α and IL-1β (p=<0.001). Propofol was superior to sevoflurane in reducing renal ischemia and oxidative stress, reflected by lower serum creatinine and proinflammatory cytokines.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: