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Renal function in surgical patients after administration of low-flow sevoflurane and amikacin

Hideyuki Higuchi1, Yushi Adachi

  • 1Department of Anesthesia, Self Defense Force Hanshin Hospital, 4-1-50 Kushiro, Kawanishi, Hyogo 666-0024, Japan.

Journal of Anesthesia
|October 21, 2003
PubMed
Abstract

Insights

This study found no increased kidney damage when amikacin was given with sevoflurane anesthesia. Combining an aminoglycoside antibiotic with sevoflurane did not worsen nephrotoxicity in surgical patients.

Area of Science:

  • Anesthesiology
  • Nephrology
  • Pharmacology

Background:

  • Compound A, a sevoflurane degradation product, is nephrotoxic in rats.
  • Aminoglycosides are known to cause nephrotoxic injury in humans.
  • Concurrent administration of nephrotoxins may potentiate renal damage.

Purpose of the Study:

  • To investigate the potential synergistic nephrotoxic effects of aminoglycosides in patients undergoing anesthesia with low-flow sevoflurane.
  • To assess the impact of amikacin on renal function markers during sevoflurane anesthesia.

Main Methods:

  • A comparative study involving 18 patients receiving amikacin and 19 control patients.
  • Both groups received sevoflurane anesthesia with low fresh gas flow (1 L/min) and cefotiam antibiotic.
  • Urinary excretion of biomarkers including total protein, albumin, beta(2)-microglobulin, glucose, and NAG was measured.
  • Amikacin was administered intravenously at 400 mg/day from anesthesia induction to day 2 post-anesthesia.

Main Results:

  • Anesthesia duration and mean Compound A concentrations were similar between the amikacin and control groups (P > 0.05).
  • Baseline renal function markers (blood urea nitrogen, serum creatinine) showed no significant differences between groups.
  • No significant differences were observed in the maximum or average urinary excretion of measured biochemical markers post-anesthesia.

Conclusions:

  • The co-administration of amikacin and sevoflurane did not result in a synergistic increase in nephrotoxicity in human surgical patients.
  • This study suggests that amikacin does not potentiate Compound A-induced nephrotoxicity under these clinical conditions.

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