ABSTRACT
Sevoflurane is a promising new nonflammable halogenated inhalational agent which produces anaesthesia of excellent quality. This study was performed to investigate experimental and clinical renal effects of sevoflurane versus isoflurane. The expermental part of study included 60 rats divided into 3 equal groups. Group I [control] was exposed to oxgen 4L/min for hours, group II [isoflurane] was exposed to 1.2% isoflueane for 2 hours, group III [sevoflurane] was exposed to 2% sevoflurane for 2 hours. Each group was further subdivided equally into two subgroups. Subgroup [A] in which animals were sacrified 24 hours after exposure, subgroup [B] in which animals were sacrified 7 days from the exposure. Animala blood samples were collected for blood urea nitrogen [BUN] and serum creatinine [Cr.] measurements, then the kidney was removed for histological and histochemical [succinic dehydrogenase enzyme activity] studies. The clinical part of this study was carried out on 40 ASAI and II of adult patients and were divided equally into two groups. Group I received 1.2 isoflurane for 2 hours and group II received sevoflurane 2% for 2 hours. Haemodynamics were assessed by measuring heart rate [HR] and mean arterial blood pressure [MBP], renal function tests [BUN and serum Cr.] was done preinduction, 2, 4,24 hours and 7 days postoperatively. Experimental study results founded that both isoflurane and sevoflurane had no effect on renal enzymes level all-through the study period. Histological examination of the kidney revealed mild congestion of central vein in sevoflurane group in contrast to isoflurane group which had severe congestion of central vein and cellular infiltration. On the other hand succinic dehydrogenase enzyme granules decreased slightly in sevoflurane but showed moderate activity in isoflurane group. The present clinical study showed that sevoflurane group had significantly lower [HR] than isoflurane group intra operatively. Also MBP was significantly lower in sevoflurane group from 5 minutes till 30 minutes intra operatively. No changes were recorded in renal enzymes all through the study period. Analysis of the data obtained from the experimental and clinical studies in this work demonstrated that sevoflurane had no harmful effect on the kidney with cardiovascular stability