Effect of anesthesia factor on kidney injury in pediatric patients undergoing living donor liver trans-plantation: a comparison of sevoflurane-versus propofol-based anesthesia / 中华麻醉学杂志

ABSTRACT

Objective To compare the effects of sevoflurane-and propofol-based anesthesia on kid-ney injury in pediatric patients undergoing living donor liver transplantation. Methods Eighty pediatric pa-tients of both sexes, aged 5-15 months, weighing 5. 5-10. 0 kg, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, scheduled for elective living donor liver transplantation, were divided into 2 groups ( n=40 each) using a random number table method: sevoflurane-based anesthesia group ( group S) and propofol-based anesthesia ( group P ) . Sevoflurane was inhaled, and the end-tidal concentration was maintained at 1. 0％-3. 0％ in group S. Propofol 9-15 mg·kg-1 ·h-1 was intravenously infused in group P. Fentanyl 1-3 μg∕kg was intermittently injected, and cisatracurium 1-2 μg·kg-1·min-1 was intrave-nously infused in two groups. Bispectral index value was maintained at 40-60. Immediately before skin in-cision ( T1 ) , at 30 min of anhepatic phase ( T2 ) , at 3 h of neohepatic phase ( T3 ) , at 24 h after operation ( T4 ) and at day 3 after surgery ( T5 ) , blood samples from the central vein and urine specimens were col-lected for determination of the levels of neutrophil gelatinase-associated lipocalin and cystatin C in serum and urine by enzyme-linked immunosorbent assay. The urine volume, requirement for dopamine and occurrence of hypotension and myocardial ischemia were recorded during surgery. Results Compared with group P, the levels of neutrophil gelatinase-associated lipocalin and cystatin in serum and urine were significantly de-creased at T3-5 ( P<0. 05) , and no significant change was found in the intraoperative urine volume, inci-dence of hypotension and myocardial ischemia, or requirement for dopamine in group S ( P>0. 05) . Con-clusion Compared with propofol-based anesthesia, kidney injury is attenuated in pediatric patients under-going living donor liver transplantation under sevoflurane-based anesthesia.