Impact of Telmisartan on glomerular filtration in laparoscopic surgery. A double blinded randomised controlled study

Background Laparoscopic surgery has begun to replace a great number of procedures that were previously practiced using open or conventional techniques. This is due to the minimal invasion, small incisions, and short time recovery. However, it has come to knowledge, that the increase in intra-abdominal pressure due to carbon dioxide pneumoperitoneum during laparoscopic surgery causes cardiovascular, respiratory, endocrine, and renal alterations. Objective To evaluate the nephroprotective effect of Telmisartan, an angiotensin II AT1 receptor antagonist, on glomerular filtration in laparoscopic surgery. Material and methods Analytical prospective, randomised, double-blind study was conducted on patients undergoing elective laparoscopic cholecystectomy. They were randomised into 2 groups, with the treatment group receiving a single dose of 40 mg Telmisartan orally 2 h prior to surgery, and the placebo group. Results There were 20 patients in each group ( n = 40), with a mean age of 32.65 years in the treatment group. Plasma creatinine did not show any significant change in the different time lapse in which blood samples were taken, but creatinine clearance at the end of surgery (196.415±56.507 vs. 150.1995±75.081; p = 0.034), and at 2 h postoperative period (162.105±44.756 vs. 113.235±31.228; p ≤ 0.001) was statistically significant, which supports an increase in renal function in the Telmisartan group. Conclusion The use of Telmisartan, an angiotensin II AT1 receptor antagonist, offers renal protection during laparoscopic surgery.