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document
Effects of halothane and isoflurane on transient renal dysfunction associated with infrarenal aortic cross-clamping . Aortic cross-clamping for reconstructive aortic surgery is associated with impairment of renal function . Halothane or isoflurane was used to assess the influence of volatile anesthesia on renal hemodynamics during aortic surgery . Nineteen patients with normal preoperative creatinine clearances who were scheduled for reconstructive aortic surgery were randomly divided into two groups : halothane group ( n = 9 ) and isoflurane group ( n = 10 ) . Induction of anesthesia consisted of midazolam , fentanyl , and pancuronium . Anesthesia was maintained with fentanyl and halothane or isoflurane in nitrous oxide and oxygen ( 50/50 ) . Systemic hemodynamics were similar in both groups throughout surgery . Before aortic cross-clamping , effective renal plasma flow ( ERPF ) ( 131I-hippuran clearance ) and glomerular filtration rate ( GFR ) ( 99Tc-DTPA clearance ) were significantly lower in the halothane group ( 118.4 +/- 25.6 and 19.7 +/- 5.2 mL/min , respectively ) than in the isoflurane group ( 253.4 +/- 51.5 and 44.9 +/- 8.4 mL/min ) ( P less than 0.05 for both ) . During cross-clamping , the renal variables were not markedly affected in either group and remained higher in the isoflurane-anesthetized patients ( 232.9 +/- 47.1 and 49.5 +/- 1.2 mL/min for ERPF and GFR , respectively ) than in the halothane-anesthetized patients ( 132.4 +/- 31.6 and 14.8 +/- 3.7 mL/min , respectively ) ( P less than 0.05 ) . After aortic unclamping , ERPF increased markedly in both groups ( 467.8 +/- 122 and 362.5 +/- 57.7 mL/min in the halothane and isoflurane groups , respectively ) , as did GFR ( 74.8 +/- 22 and 71.8 +/- 13.1 mL/min , respectively ) . These results suggest that anesthesia with halothane is associated with transient renal vasoconstriction during abdominal surgery . In contrast , aortic cross-clamping during isoflurane anesthesia was not associated with renal hemodynamic impairment .
23252
Intervention_Pharmacological
halothane
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Intervention_Pharmacological
isoflurane
23254
Intervention_Pharmacological
Halothane
23255
Intervention_Pharmacological
isoflurane
23256
Intervention_Pharmacological
halothane group
23257
Intervention_Physical
isoflurane group
23258
Intervention_Pharmacological
midazolam
23259
Intervention_Pharmacological
fentanyl
23260
Intervention_Pharmacological
pancuronium
23261
Intervention_Pharmacological
fentanyl
23262
Intervention_Pharmacological
halothane
23263
Intervention_Pharmacological
isoflurane in nitrous oxide and oxygen
23264
Intervention_Pharmacological
isoflurane
23265
Intervention_Pharmacological
halothane-anesthetized
23266
Intervention_Pharmacological
anesthesia
23267
Intervention_Pharmacological
halothane
23268
Outcome_Physical
transient renal dysfunction
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Outcome_Physical
renal function
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Outcome_Physical
renal hemodynamics
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Outcome_Physical
Systemic hemodynamics
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Outcome_Physical
effective renal plasma flow ( ERPF ) ( 131I-hippuran clearance )
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Outcome_Physical
glomerular filtration rate ( GFR ) ( 99Tc-DTPA clearance )
23274
Outcome_Physical
renal variables
23275
Outcome_Physical
ERPF
23276
Outcome_Physical
GFR
23277
Outcome_Physical
transient renal vasoconstriction
23278
Outcome_Physical
renal hemodynamic impairment
23279
Participant_Condition
transient renal dysfunction