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

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 m...

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Veröffentlicht in:International journal of medical arts 2023-09, Vol.5 (8), p.3540-3547
Hauptverfasser: Mohammed, Mohammed, Abdelsalam, Mostafa, Tawfik, Mona, Mostafa, Mona, Mohammed, Zenat
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Sprache:eng
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Zusammenfassung: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.
ISSN:2682-3780
2636-4174
2682-3780
DOI:10.21608/ijma.2023.223411.1741