Impact of Intraoperative Degrees of Hypotensive Anaesthesia Using Dexmedetomidine on Perioperative Renal Injuries in Patients Undergoing Endoscopic Sinus Surgery

Mohammed, Mohammed Nashaat; Abdelsalam, Mostafa; Tawfik, Mona; Mostafa, Mona Gad; Mohammed, Zenat Eldadamony

doi:10.21608/ijma.2023.223411.1741

	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, Page 3540-3547 PDF (904.57 K)
Document Type: Original Article
DOI: 10.21608/ijma.2023.223411.1741
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Authors
Mohammed Nashaat Mohammed ¹; Mostafa Abdelsalam ²; Mona Tawfik ²; 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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