Effect of sevoflurane-based or propofol-based anesthesia on acute kidney injury after surgery for gastric cancer: a retrospective propensity score-matched analysis.

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.