Abstract
The effects of anesthetics on acute kidney injury (AKI) after spine surgery have not been evaluated fully. This study compared propofol-based total intravenous anesthesia (TIVA) and volatile anesthetics in the development of AKI after spine surgery. This retrospective study reviewed patients who underwent spine surgery between 2015 and 2019. A logistic regression analysis was performed to identify risk factors for AKI. Additionally, after propensity score matching, the incidence of AKI was compared between TIVA and volatile groups. Of the 4473 patients, 709 were excluded and 3764 were included in the logistic regression. After propensity score matching, 766 patients from each group were compared, and we found that the incidence of AKI was significantly lower in the TIVA group (1% vs. 4.2%, p < 0.001). In the multivariate logistic regression analysis, the risk factors for postoperative AKI were male sex (OR 1.85, 95% CI 1.18–3.06), hypertension (OR 2.48, 95% CI 1.56–3.94), anemia (OR 2.66, 95% CI 1.76–4.04), and volatile anesthetics (OR 4.69, 95% CI 2.24–9.84). Compared with volatile anesthetics, TIVA is associated with a reduced risk of AKI for patients who have undergone spine surgery.
Highlights
Postoperative acute kidney injury (AKI) is associated with mortality and quality of recovery
This study investigated the association between the incidence of postoperative AKI and the main anesthetic agents used in spine surgery
No patient developed stage 3 or required renal replacement therapy. This retrospective study showed that the use of total intravenous anesthesia (TIVA) with propofol is associated with a lower incidence of AKI after spine surgery compared with the use of volatile anesthetics
Summary
Postoperative acute kidney injury (AKI) is associated with mortality and quality of recovery. It is not just an indicator of multiorgan dysfunction but is itself an important independent factor for postoperative outcome [1]. Animal experiments found that propofol has anti-inflammatory, anti-oxidative, anti-apoptotic, and immunomodulatory effects, and it reduces ischemia/reperfusion injury in kidney cells [3,4,5]. It is not yet clear whether propofol has clinically meaningful renoprotective effects compared with volatile anesthetics. The secondary purpose was to investigate the risk factors for AKI after spine surgery
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
