Introduction
This study was designed to assess and compare the effect of propofol total intravenous anesthesia as against sevoflurane volatile induction and maintenance of anesthesia during suprarenal aortic clamping as part of renal protection strategies utilizing serum creatinine and proinflammatory cytokines: tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) as stress biomarkers.
Patients and methods
A total of 30 patients scheduled for major elective abdominal suprarenal infracoeliac aortic surgery were included. Fifteen of them received propofol total intravenous anesthesia (group P) and the other 15 received sevoflurane volatile induction and maintenance of anesthesia (group S). Serum creatinine level and plasma TNF-α and IL-1β were measured at the following intervals: before the initiation of surgery (T0), 15 min after reperfusion (T1), and 24 h (T2), 48 h (T3), and 72 h (T4) after end of surgery.
Results
Group S demonstrated higher levels of serum creatinine, plasma TNF-α, and IL1-β following the release of cross-clamp than group P. The highest level of serum creatinine was observed at T2 and then values tended to decline afterward in both groups ( < 0.001), whereas a significant increase over time for both plasma TNF-α and IL-1β was observed in the two studied groups ( < 0.001); the highest levels were detected at T4.
Conclusion
In this surgical setting, propofol is superior to sevoflurane in reducing renal ischemia and oxidative stress as reflected by lower values of serum creatinine and plasma proinflammatory cytokines: TNF-α and IL-1β.