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Renal Function after Major Uro-Oncolog.c Surg.ry and Dexmedetomidine Infusion

Open Journal of Anesthesiolog. 2013年第8期3卷 356-362页

作者： Marcus Vinicius M. Novaes paulo sergio g. lavinas g.ace Haber D. Pires Ana Claudia g. de Carvalho Renata M. B. Lopes Reg.na El Dib paulo do Nascimento Jr. Cancer Institute (INCA) Rio de Janeiro Brazil Department of Anesthesiolog. Univ Estadual Paulista (UNESP) Botucatu Brazil

Objective: Acute kidney injury in major surg.ry is associated with increased postoperative mortality. This study aimed to evaluate renal function after major urolog.c surg.ry and intraoperative dexmedetomidine infusion. Methods: Thirty oncolog.c patients with normal renal function scheduled for prostatectomy or nephrectomy, anesthetized with combined epidural and g.neral anesthesia, were randomized to receive either intraoperative blind infusion of dexmedetomidine (Dexmedetomidine g.oup, n = 15, 0.5 μg.kg.load dose plus 0.7 μg.kg.h) or 0.9% saline (Control g.oup, n = 15) until the end of surg.ry. Intraoperative and cumulative 24-hour diuresis, serum creatinine (SCr), calculated creatinine clearance (ClCr) and serum cystatin C (SCys) at postoperative days 1, 2 and 3 and 2 weeks after surg.ry were evaluated. Results: Mean ± standard deviation values for intraoperative diuresis in Dexmedetomidine and Control g.oups were 566 ± 396 mL and 298 ± 153 mL, respectively (p = 0.014). Cumulative 24-hour diuresis in Dexmedetomidine and Control g.oups was 1947 ± 266 mL and 1748 ± 237 mL, respectively (p = 0.91). Mean values of SCr, ClCr and SCys were not sig.ificantly different from their baseline values in both g.oups and no sig.ificant differences were seen between g.oups at any moment for two weeks (p > 0.05). Conclusion: According.to the doses used in this study, despite an intraoperative increase in diuresis, intraoperative infusion of dexmedetomidine did not influence renal performance up to two weeks after major uro-oncolog.c surg.ry, as evaluated by SCr, ClCr and SCys.

关键词： Dexmedetomidine Renal Function Nephrectomy Prostatectomy Epidural g.neral Anesthesia

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