Agnė Kaunienė, Aistė Urbonaitė, Tadas Lenkutis, Edmundas Širvinskas, Milda Švagždienė

Abstract

The aim of the study was to find out the effect of general anesthesia combined with high thoracic epidural (HEA) and only general anesthesia (GA) on renal function after coronary artery bypass graft surgery (CABGS) with cardiopulmonary bypass (CPB). Material and methods. The study included patients (from 49 to 82 years), who had received CABGS with CPB at Lithuania university of health sciences Clinic of Cardiothoracic and vascular surgery during the period of October, 2014 to October, 2015. All patients were divided into two groups: first group (GA), which included patients who had received only GA (anaesthetics and intraveous opiates); and second group (HEA) ,which included patients who received HEA (local anaesthetic and GA anesthetics with intravenous opiates). Biochemical blood tests were run three times on each patient – before the surgery, one day after the surgery and five days after the surgery. The concentrations of blood serum creatinine and urea, which reflect kidney dysfunction, were evaluated during perioperative period. Results of the study. The average concentration of pre – operative blood serum creatinine in HEA group was 93,3 ± 16 mmol /l, in GA group – 95,3 ± 23,5 mmol / l (p> 0,05). The average concentration of serum creatinine on first postoperative day in HEA group was 101,3 ± 19,3 mmol / l, in GA group – 104,81 ± 37 mmol / l (p <0,05). The average of blood serum creatinine concentration on the fifth postoperative day in HEA group was 97±14,3mmol / l, in GA group – 103,7 ± 31,6 mmol/l (p <0,05). The average pre – operative blood serum urea concentration in HEA group was 4,2 ± 1,2 mmol / l, in GA group 5,2 ± 1,7 mmol/l (p>0,05). The average concentration of serum urea on first postoperative day in HEA group was 5,6±1,8 mmol/l, in GA group 6,2 ±2,0 mmol/l. (p >0,05). The average of blood serum urea concentration on the fifth postoperative day in HEA group was 4,7 ± 1,3 mmol / l,in GA group 5,8 ± 3 mmol/l (p <0,05). Findings of the study. When comparing the concentrations of blood serum creatinine and urea before the surgery, one day after the surgery and five days after the surgery, lower changes of both indicators are observed in the HEA group than in the GA group.

Keyword(s): high epidural anesthesia; acute kidney injury.
DOI: 10.5200/sm-hs.2016.054
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