Impact of Intraoperative Degrees of Hypotensive Anaesthesia Using Dexmedetomidine on Perioperative Renal Injuries in Patients Undergoing Endoscopic Sinus Surgery | ||
| International Journal of Medical Arts | ||
| Article 8, Volume 5, Issue 8, August 2023, Pages 3540-3547 PDF (904.57 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ijma.2023.223411.1741 | ||
| Authors | ||
| Mohammed Nashaat Mohammed* 1; Mostafa Abdelsalam2; Mona Tawfik2; Mona Gad Mostafa1; Zenat Eldadamony Mohammed1 | ||
| 1Department of Anaesthesia, Pain Medicine and Surgical ICU, Faculty of Medicine, Mansoura University, Mansoura, Egypt | ||
| 2Department of Internal Medicine [Nephrology and Dialysis Unit], Faculty of Medicine, Mansoura University, Mansoura, Egypt | ||
| Abstract | ||
| Background and objective: Although controlled intraoperative hypotension is essential in functional endoscopic sinus surgery [FESS], it could lead to vital organ hypoperfusion. Herein, we evaluated the effects of maintaining mean blood pressure [BP] around 60 mmHg on renal function compared to its maintenance around 70 mmHg. Patients and Methods: We included 134 patients undergoing FESS procedure in this randomized prospective trial. Patients were divided into two groups; mean BP was kept around 70 mmHg in group A participants, while the same parameter was kept around 60 mmHg in group B patients. Preoperative and intraoperative kidney function were evaluated by the resistive index. Results: Most preoperative parameters were statistically comparable between the two groups. Group B patients had better surgical field quality. The incidence of acute kidney injury [AKI] was 9% and 20.9% in Groups A and B, respectively [p = 0.052]. However, the intraoperative resistive index showed a marked increase in Group B [0.81 vs. 0.75 in Group A]. High baseline creatinine and a high intraoperative resistive index were independent predictors for AKI. High postoperative serum creatinine was also a significant risk factor. Conclusion: A high preoperative creatinine and intraoperative resistive index are strong risk factors for AKI. | ||
| Keywords | ||
| Intraoperative hypotension; Renal injury; Predictors; Resistive index | ||
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