对于2型糖尿病患者的术后功能,sevoflurane和desflurane的比较作用
Jae Hyon Park1, Insun Park2, Sangun Nah3
1Department of Radiology, Armed Forces Daejeon Hospital, Daejeon, Korea.
Renal failure
|November 26, 2025
概括
在2型糖尿病 (T2DM) 患者中,sevoflurane 麻醉可能会增加脏损伤的风险,患者的脏皮层脂肪分数 (RCFF) 较低. 低于2%的RCFF患者在使用sevoflurane时表现出更高的eGFR下降率.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 麻醉学 麻醉学
- 放射学 放射学是一门学科.
背景情况:
- 塞沃弗兰是一种常见的麻醉剂,但其毒性令人担忧,特别是在2型糖尿病患者 (T2DM) 中.
- 通过MRI评估的皮皮质脂肪分数 (RCFF) 可能表明脏健康状况.
- 这项研究研究了sevoflurane和desflurane在T2DM患者的对比性效应.
研究的目的:
- 在T2DM患者中,比较sevoflurane和desflurane麻醉之间持续估计的淋巴球过率 (eGFR) 降低的发生率.
- 确定eGFR衰退的预测因素,特别关注手术前的RCFF.
- 评估低RCFF是否影响对麻醉引起的毒性敏感性.
主要方法:
- 对成人T2DM患者进行过非心脏手术>3小时的回顾性队列研究.
- 包括手术前腹部MRI患者,包括质子密度脂肪分数序列.
- 倾向性得分匹配 (PSM) 和多变量逻辑回归被用于分析eGFR下降并确定预测因素.
主要成果:
- 在PSM后,分析了158名患者,57.6%的患者经历了持续的eGFR下降,而sevoflurane和desflurane组之间没有显著差异.
- 在手术前较低的eGFR和RCFF是eGFR下降的独立预测因子,仅限于sevoflurane组.
- 与RCFF≥2% (53.3%,p=0.040) 患者相比,RCFF<2%的患者在sevoflurane (81.8%) 下显示出显著更高的eGFR下降率,但在desflurane下没有.
结论:
- 患有低RCFF (<2%) 的2型糖尿病患者可能在sevoflurane麻醉后更容易患上术后功能障碍.
- 手术前的RCFF评估可能会识别T2DM患者有较高的风险与sevoflurane相关的毒性.
- 需要进一步的研究来验证低RCFF和sevoflurane诱导的T2DM脏影响之间的关联.
更多相关视频
03:02Application of Dixon's Up-and-Down Design to Estimate the Minimum Alveolar Concentration of Sevoflurane in Rats with Refined Movement Classification
Published on: July 25, 2025
492
04:56In Vitro Method to Control Concentrations of Halogenated Gases in Cultured Alveolar Epithelial Cells
Published on: October 23, 2018
7.0K
相关概念视频
01:20Inhalational Anesthetics: Overview
964
Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
964
01:24Parenteral Anesthetics: Overview
554
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
554
01:22Diabetes Mellitus: Type 2 and Gestational
4.3K
Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
4.3K
01:19Imaging Studies VII: Vascular Imaging
294
DefinitionRenal angiography, also known as renal arteriography, is an imaging technique used to obtain a comprehensive view of blood flow and the vascular structure of blood vessels in the kidneys and surrounding areas.PurposeRenal angiography detects blood vessel abnormalities in the kidneys, such as aneurysms, stenosis, thrombosis, vascular tumors, and renal artery stenosis. It evaluates kidney function and guides interventional treatments like angioplasty or stent placement.Pre-Procedure...
294
01:25Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant
198
In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...
198
01:17Oral Hypoglycemic Agents: Sulfonylureas
733
Sulfonylureas are oral hypoglycemic agents utilized in treating type 2 diabetes. They are characterized by their unique sulfonylurea chemical structure. The family of sulfonylureas is divided into generations. First-generation sulfonylureas, including tolbutamide (Orinase), chlorpropamide (Diabinese), and tolazamide (Tolinase), trigger insulin release from pancreatic β cells and enhance peripheral tissues' insulin sensitivity. The second-generation members, such as glipizide...
733