Effect of dexmedetomidine on renal function in pediatric patients undergoing living donor liver transplantation / 中华麻醉学杂志

ABSTRACT

Objective To evaluate the effect of dexmedetomidine on renal function in pediatric pa-tients undergoing living donor liver transplantation. Methods Sixty pediatric patients of both sexes with congenital biliary atresia, aged 5-15 months, weighing 5. 5-10. 0 kg, of American Society of Anesthesiol-ogists physical status Ⅱ or Ⅲ, scheduled for elective living donor liver transplantation, were randomly di-vided into either control group (group C) or dexmedetomidine group ( group D) with 30 patients in each group. The infants were tracheally or nasotracheally intubated and mechanically ventilated after induction of anesthesia. Dexmedetomidine was intravenously infused in a loading dose of 1 μg∕kg for 10 min, followed by a continuous infusion of 0. 3 μg·kg-1·h-1until the end of operation in group D. While the equal vol-ume of normal saline was given instead of dexmedetomidine in group C. At skin incision (T1), at 30 min of anhepatic phase (T2), at 1 h of neohepatic phase ( T3), immediately after peritoneum closure ( T4) and at 24 h after operation (T5), blood samples from the central vein and urine specimens were collected for determination of creatinine and blood urea nitrogen (BUN) concentrations in serum (by colorimetric assay) and β2-microglobulin (β2-MG) concentrations in serum and urine (using immunoturbidimetric method), and concentrations of tumor necrosis factor-α, interleukin-6 (IL-6) and IL-18 in serum (by enzyme-linked immunosorbent assay). The urine volume was recorded during surgery. Results Compared with group C, the urine volume was significantly increased, and the serum creatinine, BUN and β2-MG concentrations and urine β2-MG concentrations at T3-5, serum BUN concentrations at T4,5, and serum tumor necrosis fac-tor-α, IL-6 and IL-18 concentrations at T2-5were decreased in group D (P＜0. 05). Conclusion Dexme-detomidine can improve renal function in pediatric patients undergoing living donor liver transplantation.