Effects of closed-circuit sevoflurane anesthesia on hepato-renal function

Abstract

Objective To assess the hepato-renal function after closed-circuit anesthesia with sevoflurane. Methods Forty ASA Ⅰ orⅡ patients aged 20-60 yr undergoing operation lasting more than 120 min under general anesthesia were randomized to receive either domestically-produced sevoflurane (group D, n=20) or imported sevoflurane (group Ⅰ, n=20). Fresh gas flow was first set at 2-4 L/min for 2-3 min then reduced to 0.18-0.30 L/min. The end-tidal sevoflurane concentration was maintained at 2.6%-3.5%. ECG, BP, HR, SpO2, PETCO2, ispiratory and expiratory O2 and sevoflurane concentrations were continuously monitored during operation. Blood samples were taken from peripheral vein before anesthesia (T0 ,baseline), at the end of surgery (T1) and 1, 2, 3, 5 d after operation (T2.5) for determination of serum alanine transaminase (ALT), aspartate transaminase (AST) activity, total bilirubin (TB), creatinine (Cr), blood urea nitrogen (BUN) and β2 microglobulin (β2-MG) concentrations. Urine specimens were taken for determination of β2-MG concentration at the same time periods. Resuits There were no significant differences in serum ALT, AST activity, TB, Cr, BUN and β2-MG concentrations before and after operation as well as between the 2 groups. Β2-MG concentration in urine was significantly increased at T1-3 as compared with the baseline value at To in both groups but was not significandy different between the 2 groups. Conclusion Closed-circuit anesthesia with sevoflurane has no significant adverse effect on hepato-renal function. Key words: Anesthetics, inhalation; Anesthesia, closed-circuit; Liver function tests; Kidney function tests