ABSTRACT

Numerous studies have indicated nephrotoxic effects of sevoflurane because of its two bioproducts compound A and fluoride. Cystatin C (CyC) is a more sensitive biomarker than creatinine to show early and mild changes in kidney function. We designed this prospective randomised study to compare the effects of low-flow sevoflurane anaesthesia and low-flow desflurane anaesthesia on renal functions based on CyC levels. No studies have evaluated the effects of low-flow sevoflurane anaesthesia on renal functions based on CyC levels to date.

Thirty American Society of Anesthesiologists (ASA) physical status I–II patients who were scheduled for urological procedures were enrolled in this study. The patients were randomly assigned to 2 groups: low-flow sevoflurane anaesthesia or low-flow desflurane anaesthesia. Serum urea, creatinine and CyC levels were measured before the operation, just before extubation and 24 h after the operation. Creatinine clearance was calculated in the first 24-h urine sample.

There were no significant differences in serum urea, creatinine and CyC levels or 24 h creatinine clearance between the groups.

Our study demonstrates with a more sensitive biomarker, CyC, that low-flow sevoflurane anaesthesia is safe in terms of the effects on renal function.

Keywords: Low-flow anaesthesia, sevoflurane, deslurane, cystatin C, renal dysfunction