A randomized controlled trial on the impact of anesthetic agents on renal function in cardiac surgery with cardiopulmonary bypass.

Abstract

Acute kidney injury (AKI) is a frequent and severe problem following heart surgery, particularly in procedures involving cardiopulmonary bypass (CPB). This research investigates the Randomized Controlled Trial (RCT) on the impact of agents of anesthetic on renal function in patients receiving elective cardiac surgery and CPB, comparing propofol-based and volatile anesthetic-based regimens. A sum of 61 patients was randomly assigned into two regions: one receiving a propofol-based regimen and the other, a volatile anesthetic regimen, both combined with opioid analgesia. Renal function was assessed preoperatively and postoperatively at 24 and 48 h using serum creatinine and cystatin C levels. Perioperative inflammatory markers were deliberate to evaluate inflammation-mediated renal impairment multivariate logistic regression identified risk factors for AKI, and independent t-tests compared renal function parameters between regimens. Patients receiving propofol exhibited significantly lower rates of AKI ( $\text{p}<0.05$ ) and reduced inflammatory marker levels associated to the volatile anesthetic regimen. These results present that propofol anesthesia provides a protecting influence on renal function, likely due to its anti-inflammatory properties. The research emphasizes the necessity of choosing the right anesthetic for postoperative kidney outcomes by tailoring anesthetic regimens to mitigate AKI risk in high-risk populations. Propofol's protective role against AKI offers potential clinical value, particularly in cardiac surgeries requiring CPB. Further investigation with bigger cohorts and continued follow-up are necessary for verifying these findings and exploring their broader applicability in cardiac anesthesia.