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[Renal function after anesthesia and abnormal surgery. A comparative study between halothane and epidural

F Yasuma, J Akune, S Hirose

    Nihon Geka Gakkai Zasshi
    |December 1, 1983
    PubMed
    Summary
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    Post-abdominal surgery, urinary beta 2-microglobulin (BMG) increased, indicating tubular dysfunction. Epidural anesthesia showed faster recovery than halothane anesthesia, suggesting less kidney impact.

    Area of Science:

    • Nephrology
    • Anesthesiology
    • Surgical Research

    Background:

    • Abdominal surgery and anesthesia can impact renal function.
    • Beta 2-microglobulin (BMG) is a marker of tubular damage.
    • Osmolarity (OSM), creatinine clearance (Ccr), and free water clearance (C-H2O) are indicators of kidney function.

    Purpose of the Study:

    • To evaluate the effects of halothane versus epidural anesthesia on renal function post-abdominal surgery.
    • To assess changes in urinary BMG, OSM, Ccr, and C-H2O after surgery.
    • To determine if anesthesia type influences the extent and duration of postoperative tubular dysfunction.

    Main Methods:

    • Measured plasma and urinary BMG and OSM in 23 adult female patients before and after abdominal surgery.
    • Simultaneously determined creatinine clearance (Ccr) and free water clearance (C-H2O).

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  • Divided patients into two groups: halothane anesthesia (n=14) and epidural anesthesia (n=9).

    • Main Results:

    • Creatinine clearance temporarily increased in both groups postoperatively.
    • Urinary BMG significantly increased after surgery, while plasma BMG remained unchanged.
    • Urinary BMG normalized faster in the epidural anesthesia group (2-POD) compared to the halothane group (4-POD).

    Conclusions:

    • Postoperative tubular dysfunction is evident following abdominal surgery and anesthesia, indicated by elevated urinary BMG.
    • Epidural anesthesia appears to cause less tubular dysfunction than halothane anesthesia, evidenced by quicker BMG recovery.
    • Urinary BMG is a sensitive marker for detecting postoperative tubular dysfunction, potentially more so than OSM, Ccr, or C-H2O.