ABSTRACT
BACKGROUND: Postoperative acute kidney injury (AKI) is a significant complication after coronary artery bypass surgery. Prior coronary angiography increases the likelihood of AKI due to the use of a radiocontrast dye. This study examined the effect of coronary angiography on the postoperative renal function after off-pump coronary artery bypass surgery (OPCAB). METHODS: The records of 110 patients who required OPCAB were reviewed. These patients also had at least two of the following conditions: chronic kidney disease, hypertension, diabetes mellitus, emergency surgery, congestive heart failure, age >75 years, hematocrit or =50% or > or =0.3 mg/dl within 48 hours. RESULTS: The postoperative changes in the SCr, cystatin C and eGFR were similar in the two groups. The incidence of AKI and renal replacement therapy were similar in the two groups. CONCLUSIONS: Coronary angiography performed within two days of OPCAB does not affect the postoperative renal function.
Subject(s)
Humans , Acute Kidney Injury , Angiotensin Receptor Antagonists , Angiotensin-Converting Enzyme Inhibitors , Coronary Angiography , Coronary Artery Bypass , Coronary Artery Bypass, Off-Pump , Creatinine , Cystatin C , Diabetes Mellitus , Emergencies , Glomerular Filtration Rate , Heart Failure , Hematocrit , Hypertension , Incidence , Kidney , Postoperative Period , Renal Insufficiency, Chronic , Renal Replacement Therapy , Stroke VolumeABSTRACT
BACKGROUND: Postoperative acute kidney injury (AKI) is a significant complication after coronary artery bypass surgery. Prior coronary angiography increases the likelihood of AKI due to the use of a radiocontrast dye. This study examined the effect of coronary angiography on the postoperative renal function after off-pump coronary artery bypass surgery (OPCAB). METHODS: The records of 110 patients who required OPCAB were reviewed. These patients also had at least two of the following conditions: chronic kidney disease, hypertension, diabetes mellitus, emergency surgery, congestive heart failure, age >75 years, hematocrit or =50% or > or =0.3 mg/dl within 48 hours. RESULTS: The postoperative changes in the SCr, cystatin C and eGFR were similar in the two groups. The incidence of AKI and renal replacement therapy were similar in the two groups. CONCLUSIONS: Coronary angiography performed within two days of OPCAB does not affect the postoperative renal function.
Subject(s)
Humans , Acute Kidney Injury , Angiotensin Receptor Antagonists , Angiotensin-Converting Enzyme Inhibitors , Coronary Angiography , Coronary Artery Bypass , Coronary Artery Bypass, Off-Pump , Creatinine , Cystatin C , Diabetes Mellitus , Emergencies , Glomerular Filtration Rate , Heart Failure , Hematocrit , Hypertension , Incidence , Kidney , Postoperative Period , Renal Insufficiency, Chronic , Renal Replacement Therapy , Stroke VolumeABSTRACT
BACKGROUND: We investigated the effect that replacement with Ringer's lactate (RL) for preoperative NPO deficits might have on blood glucose concentration in children undergoing strabismus surgery. METHODS: Sixty children scheduled for strabismus surgery were enrolled in this study and RL was administered to all subjects for replacement of preoperative NPO deficits.Patients were randomly assigned to three groups according to the types of maintenance fluid employed during anesthesia.RL, 5% dextrose in one-fourth strength normal saline (D51/4NS), and an equal volume of D(5)1/4NS and RL each were used as maintenance fluids for Group 1, 2, and 3, respectively.After glycopyrrolate 0.004 mg/kg IV, anesthesia was induced with propofol 3 mg/kg and rocuronium 0.6 mg/kg.After tracheal intubation, anesthesia was maintained with 2-3 vol% sevoflurane in 50% air with oxygen.Blood glucose concentrations were checked from blood samples through a 22 gauge catheter inserted into a saphenous vein at the time of induction, 30 and 60 min after induction of anesthesia. RESULTS: There were no significant differences in baseline blood glucose levels at the time of induction of anesthesia among three groups.And the mean blood glucose concentrations remained unchanged throughout the study period in all groups.None of the patients were found to be hypoglycemic or hyperglycemic throughout the study period. CONCLUSIONS: This study shows that the replacement of preoperative NPO deficits with RL maintains the blood glucose concentration within physiological range throughout the operation and anesthetic recovery phase, regardless of the types of maintenance fluid.
Subject(s)
Child , Humans , Androstanols , Anesthesia , Blood Glucose , Catheters , Glucose , Glycopyrrolate , Hyperglycemia , Hypoglycemia , Intubation , Isotonic Solutions , Lactic Acid , Methyl Ethers , Propofol , Saphenous Vein , StrabismusABSTRACT
BACKGROUND: Sympathetic stimulation associated with post-craniotomy pain might subsequently increase blood pressure resulting in postoperative complications. We studied whether scalp nerve blocks would reduce the severity of postoperative pain. METHODS: Thirty-two patients undergoing craniotomy were randomly allocated to either the ropivacaine group (n = 16) or the saline group (n = 16). After the skin closure, we carried out scalp nerve blocks with ropivacaine (0.75%) or saline (0.9%). Visual analog scale scores (VAS), mean arterial pressure, and heart rate were measured at 0.5, 1, 2, 4, 6, 12, 24, and 48 h after extubation. Tramadol 50 mg iv was used as rescue analgesic. The delay before administration of the first analgesic and cumulative dose of rescue analgesic for the first 48 h postoperatively were measured. RESULTS: The ropivacaine group had lower analgesic requirements than the saline group (P = 0.008). The delay before administration of the first analgesic was not different significantly between two groups. VAS was similar between the two groups at each time interval. Postoperative MAP and HR were not significantly different between two groups. VAS did not correlate with these hemodynamic variables. CONCLUSIONS: Although scalp nerve blocks with ropivacaine reduced the analgesic requirement, they did not provide the sufficient pain relief.