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Comparison of the effects of sevoflurane and total intravenous anaesthesia in percutaneous nephrolithotomy

Published online by Cambridge University Press:  12 July 2005

S. Atici  and
A. Aribogan
S. Atici
Affiliation:
University of Mersin, Department of Anaesthesiology, Mersin, Turkey
A. Aribogan
Affiliation:
University of Cukurova, Department of Anaesthesiology, Cukurova, Turkey
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Abstract

Summary

Background and objective: Although percutaneous nephrolithotomy has many advantages over open surgery, some endocrine and haemodynamic responses have been reported. However, the effects of anaesthetic agents on these responses have not previously been reported. This study compared the effects of sevoflurane and total intravenous anaesthesia using propofol and alfentanil on the haemodynamic and hormonal changes during percutaneous nephrolithotomy.

Methods: Forty-two ASA I–II patients aged between 15 and 65 yr were studied. Sevoflurane in Group S (21 patients) or TIVA in Group TIVA (21) was used for the maintenance of anaesthesia. Haemodynamic variables and serum concentrations of sodium and potassium were measured before, during and after the procedure. Arterial blood-gas status, plasma renin, aldosterone and adrenocorticotrophic hormone concentrations were measured before and during the procedure.

Results: Mean heart rate was lower during percutaneous nephrolithotomy in Group TIVA compared with Group S (P < 0.01). The mean systolic and diastolic arterial pressures were not different in both groups at any stage of measurement (P < 0.05). Plasma renin, aldosterone and adrenocorticotrophic hormone concentrations were increased during percutaneous nephrolithotomy in both groups, but the increase was greater in Group S (P < 0.05).

Conclusions: In the sevoflurane group, the concentrations of renin, aldosterone and adrenocorticotrophic hormone were significantly higher after 15 min of irrigation compared with the total intravenous anaesthesia group. Although the clinical significance of this difference was not clear, these changes should be considered in certain patient groups.

Keywords

ANAESTHETICS, INHALATION, sevofluraneANAESTHETICS, INTRAVENOUS, propofolHORMONESaldosterone, corticotrophin, reninUROLOGICAL SURGICAL PROCEDURES, URINARY DIVERSION, nephrostomy, percutaneous
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 20 , Issue 8 , September 2003 , pp. 653 - 657
Copyright
2003 European Society of Anaesthesiology

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