A Prospective Randomised Comparative Study of the Effect of Propofol and Sevoflurane on Liver and Renal Function...

Background and aim Thoracolumbar spine surgeries involve physiological stress that may influence hepatic and renal parameters. This study aimed to compare the effects of propofol-based anaesthesia with sevoflurane-based anaesthesia on liver function tests (LFTs), renal function tests (RFTs) and early postoperative recovery parameters in patients undergoing elective thoracolumbar spine surgery. Materials and methods This prospective randomised comparative study included 56 adult patients classified as American Society of Anesthesiologists (ASA) physical status I-II, who were randomly allocated into two groups (n = 28 each). Group P received intravenous (IV) propofol infusion (100-200 µg/kg/minute), while Group S received inhalational sevoflurane (0.8-1.5 minimum alveolar concentration {MAC}). Primary outcomes included serum aspartate aminotransferase (AST), alanine aminotransferase (ALT) and creatinine, measured preoperatively, immediately after extubation and at 24 hours postoperatively. Secondary outcomes included intraoperative hemodynamic stability, Ramsay Sedation Scale (RSS) scores and the incidence of postoperative nausea and vomiting (PONV). Results Both groups maintained stable intraoperative hemodynamics, with no significant differences (p > 0.05). At 24 hours, Group S demonstrated significantly higher AST, ALT and creatinine levels compared to Group P (p < 0.001). The incidence of PONV was also significantly higher in Group S (66.7% versus 33.3%; p = 0.029), while sedation scores remained comparable. Conclusion Propofol-based anaesthesia was associated with better early postoperative hepatorenal preservation and a lower incidence of PONV compared to sevoflurane, with similar intraoperative hemodynamic stability.