Effect of sevoflurane-based or propofol-based anesthesia on acute kidney injury after surgery for gastric cancer: a retrospective propensity score-matched analysis.
Yang Song, Si Liang, Ming Wei, Hong Chen, Liping Wang, Yu Wang
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引用次数: 0
Abstract
Background: Acute kidney injury (AKI) is a common complication of major abdominal surgery that is associated with adverse patient outcomes including death. The objective of this study was to investigate the incidence of postoperative AKI after gastric cancer surgery, comparing patients who received propofol-based TIVA with those who received sevoflurane-based INHA.
Methods: We analyzed the medical records of all patients aged 19 years or older who underwent radical surgery for primary gastric cancer at the Harbin Medical University Cancer Hospital between January 2010 and September 2018. 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.
Results: 3533 patients were included in the study. After propensity score matching, 1206 patients were assigned to each group. The logistic regression analysis showed that the incidence of AKI was not different in the two groups before (OR 1.05, 95% CI 0.80 to 1.38, P = 0.731) and after propensity score matching (OR 1.02, 95% CI 0.71 to 1.47, P = 0.926). Before propensity score matching, acute kidney injury occurred in 146 sevoflurane and 85 propofol patients. The overall incidence was 6.4% in the sevoflurane group and 6.7% in the propofol group. After propensity score matching, acute kidney injury occurred in 60 sevoflurane and 61 propofol patients. The overall incidence was 5.0% in the sevoflurane group and 5.1% in the propofol group.
Conclusion: In this retrospective study, no significant difference was found in the incidence of postoperative AKI after gastrectomy between patients who received propofol-based TIVA and those who received sevoflurane-based INHA in this retrospective study.
背景：急性肾损伤（AKI）是腹部大手术的常见并发症，与包括死亡在内的不良患者结局相关。本研究的目的是调查胃癌手术后AKI的发生率，比较基于异丙酚的TIVA患者和基于七氟醚的INHA患者。方法：我们分析了2010年1月至2018年9月期间在哈尔滨医科大学肿瘤医院接受原发性胃癌根治性手术的所有19岁及以上患者的病历。倾向评分匹配后，比较异丙酚组和七氟醚组术后前3天AKI的发生率。结果：共纳入3533例患者。倾向评分匹配后，每组1206例患者。logistic回归分析显示，两组患者在倾向评分匹配前（OR 1.05, 95% CI 0.80 ~ 1.38, P = 0.731）和倾向评分匹配后（OR 1.02, 95% CI 0.71 ~ 1.47, P = 0.926） AKI发生率无显著差异。在倾向评分匹配前，146例七氟醚患者和85例异丙酚患者发生急性肾损伤。七氟醚组总发生率为6.4%，异丙酚组为6.7%。经倾向评分匹配，60例七氟醚患者和61例异丙酚患者发生急性肾损伤。七氟醚组总发生率为5.0%，异丙酚组为5.1%。结论：本回顾性研究发现，以异丙酚为基础的TIVA组与以七氟醚为基础的INHA组胃切除术后AKI发生率无显著差异。
期刊介绍：
BMC Anesthesiology is an open access, peer-reviewed journal that considers articles on all aspects of anesthesiology, critical care, perioperative care and pain management, including clinical and experimental research into anesthetic mechanisms, administration and efficacy, technology and monitoring, and associated economic issues.
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