Study of the effect of sevoflurane and isoflurane anesthesia on postoperative renal dysfunction of severe fracture

Abstract

[Objective] To investigate the effect of sevoflurane and isoflurane anesthesia on the renal function of patients with severe fracture after surgery.[Methods] Sixty-two patients with severe fracture who needed surgery were enrolled and all received general anesthesia.All the patients were divided by random digits table method into two groups with 31 cases each:sevoflurane group(anesthesia maintenance with 1.5％-3.0％ sevoflurane)and isoflurane group(anesthesia maintenance with 1.5％-3.0％ isoflurane).The patients in two groups received 0.1-0.2 μg/(kg·min)remifentanll continuous intravenous infusion and atracuurium intermittent intravenous injection for anesthesia maintenance.Serum creatinine(SCr)and blood urea nitrogen(BUN)in two groups after surgery were compared,as well as the number of hemodialysis.[Results]SCr and BUN at 1,3,7 d after surgery in two groups were significantly lower than those before surgery[seveflurane group:(517 ± 187),(163 ± 110),(103 ± 99)μ mol/L vs.(853 ± 220)μmol/L,(17.1 ± 7.8),(9.5 ± 4.1),(9.7 ± 3.8)mmol/L vs.(21.8 ± 9.3)mmol/L;isoflurane group:(539 ± 188),(136 ± 108),(101 ± 95)μ mol/L vs.(881 ± 220)μmol/L,(17.5 ± 7.4),(9.5 ± 3.5),(9.8 ± 3.3)mmol/Lvs.(20.0 ± 8.9)mmol/L](P ＜ 0.05).SCr and BUN between two groups at every time point after surgery had no statistical significance(P ＞ 0.05).There was 1 case(3.2％)in sevoflurane group needed hemodialysis within 7 d after surgery,as well as in isoflurane group,and there was no statistical significance between two groups(P＞0.05).[Conclusions] For patients with severe fracture who need general anesthesia and surgery,sevoflurane and isoflurane both have no significant adverse reaction to renal function.Therefore,it is acceptable for the patients to use sevoflurane for anesthesia and it is worthy of clinical popularization and application. Key words: Fractures; bone; Sevoflurane; Isoflurane; Renal function