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Effect of sevoflurane-based or propofol-based anaesthesia on the incidence of postoperative acute kidney injury

A retrospective propensity score-matched analysis

Oh, Tak Kyu; Kim, Jinhee; Han, Sunghee; Kim, Kwanmien; Jheon, Sanghoon; Ji, Eunjeong

European Journal of Anaesthesiology (EJA): September 2019 - Volume 36 - Issue 9 - p 649–655
doi: 10.1097/EJA.0000000000001020
Pharmacology
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BACKGROUND Propofol may help to protect against ischaemic acute kidney injury (AKI); however, research on this topic is sparse.

OBJECTIVE The current study aimed to investigate whether there were differences in the incidence of postoperative AKI after lung resection surgery between patients who received propofol-based total intravenous anaesthesia (TIVA) and those who received sevoflurane-based inhalational anaesthesia.

DESIGN A retrospective observational study.

SETTING A single tertiary care hospital.

PATIENTS Medical records of patients aged 19 years or older who underwent curative lung resection surgery for nonsmall cell lung cancer between January 2005 and February 2018 were examined.

MAIN OUTCOME MEASURES After propensity score matching, the incidence of AKI in the first 3 postoperative days was compared between patients who received propofol and those who received sevoflurane. Logistic regression analyses were also used to investigate whether propofol-based TIVA lowered the risk of postoperative AKI.

RESULTS The analysis included 2872 patients (1477 in the sevoflurane group and 1395 in the propofol group). After propensity score matching, 661 patients were included in each group; 24 (3.6%) of the 661 patients in the sevoflurane group developed AKI compared with 23 (3.5%) of the 661 patients in the propofol group (95% confidence intervals of difference in incidence −0.019 to 0.022, P = 0.882). The logistic regression analyses revealed that the incidence of AKI was not different in the two groups (odds ratio 0.96, 95% confidence interval 0.53 to 1.71, P = 0.882).

CONCLUSION In this retrospective study, no significant difference was found in the incidence of postoperative AKI after lung resection surgery between patients who received propofol-based TIVA and those who received sevoflurane-based inhalational anaesthesia. Considering the methodological limitation of this retrospective study, further studies are required to confirm these results.

From the Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam-si (TKO, JK, SH), Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul (JK, SH), Department of Thoracic Surgery (KK, SJ) and Medical Research Collaborating Center, Seoul National University Bundang Hospital, Seongnam-si, South Korea (EJ)

Correspondence to Tak Kyu Oh, Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 166, Gumi-ro, Bundang-gu, Seongnam-si 13620, Gyeonggi-do, South Korea Tel: +82 31 787 7501; fax: +82 31 787 4063; e-mail: airohtak@hotmail.com

Published online 15 May 2019

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© 2019 European Society of Anaesthesiology