Sevoflurane vs. Propofol Anaesthesia and the Risk of Perioperative Acute Kidney Injury.

Abstract

Sevoflurane has been suggested to lower the incidence of acute kidney injury (AKI) after heart surgery compared to intravenous anaesthetics. However, recent studies indicated opposite results. Therefore, this meta-analysis was conducted on randomised controlled trials (RCTs) to determine if sevoflurane decreases the risk of AKI compared to propofol. Relevant RCTs were identified from PubMed, EMBASE databases, and reference lists of reviews and related articles till June 6, 2023. Review Manager was used for statistical analysis. In this study, 10 RCTs were included. Compared with propofol, sevoflurane increased the incidence of AKI (odds ratio [OR], 2.74; 95% confidence interval [CI], 1.62-4.65; p = 0.0002; I2 = 13%) and prolonged the length of intensive care unit (standard mean difference [SMD], 0.29; 95% CI, 0.06-0.53; p = 0.01; I2 = 0%) and hospital stays (mean difference [MD], 1.62; 95% CI, 0.59-2.64; p = 0.002; I2 = 0%). Based on current evidence, sevoflurane was linked to an increased risk of perioperative AKI compared to propofol. To verify the results, more high-quality RCTs are necessary. Key Words: Acute kidney injury, Sevoflurane anaesthesia, Propofol anaesthesia, Perioperative renal complications, Serum creatinine.