General anesthesia type does not influence serum levels of neutrophil gelatinase-associated lipocalin during the perioperative period in video laparoscopic bariatric surgery

Abstract

OBJECTIVES:Video laparoscopic bariatric surgery is the preferred surgical technique for treating morbid obesity. However, pneumoperitoneum can pose risks to the kidneys by causing a decrease in renal blood flow. Furthermore, as in other surgical procedures, laparoscopic bariatric surgery triggers an acute inflammatory response. Neutrophil gelatinase-associated lipocalin is an early and accurate biomarker of renal injury, as well as of the inflammatory response. Anesthetic drugs could offer some protection for the kidneys and could attenuate the acute inflammatory response from surgical trauma. The objective of this study was to compare the effects of two types of anesthetics, propofol and sevoflurane, on the serum levels of neutrophil gelatinase-associated lipocalin during the perioperative period in laparoscopic bariatric surgery.METHODS:Sixty-four patients scheduled for laparoscopic bariatric surgery were randomized into two anesthesia groups and were administered either total intravenous anesthesia (propofol) or inhalation anesthesia (sevoflurane). In the perioperative period, blood samples were collected at three time points (before anesthesia, 6 hours after pneumoperitoneum and 24 hours after pneumoperitoneum) and urine output was measured for 24 hours. Acute kidney injuries were evaluated by examining both the clinical and laboratory parameters during the postoperative period. The differences between the groups were compared using non-parametric tests. ReBEC (http://www.ensaiosclinicos.gov.br/rg/recruiting/): RBR-8wt2fyRESULTS:None of the patients developed an acute kidney injury during the study and no significant differences were found between the serum neutrophil gelatinase-associated lipocalin levels of the groups during the perioperative period.CONCLUSION:The choice of anesthetic drug, either propofol or sevoflurane, did not affect the serum levels of neutrophil gelatinase-associated lipocalin during the perioperative period in laparoscopic bariatric surgery.

Retrospective assessment of the association between inhalation anesthesia and post-operative complications in morbidly obese patients undergoing bariatric surgery

“…Our study found no significant difference between the two groups in post-operative creatinine levels. In a study with 64 patients who underwent bariatric surgery, Fernandes et al [20] determined acute kidney damage with neutrophil gelatinaseassociated lipocalin and found no significant difference between the TIVA and volatile anesthesia groups.…”

Effects of pneumoperitoneum on kidney injury biomarkers: A randomized clinical trial

“…Although our aim was to focus on pneumoperitoneum as the only factor in the study, such limitations may explain the lack of difference for different pressure ranges. In a study using NGAL in patients undergoing bariatric procedures with mean pressure of 12 mm Hg and pneumoperitoneum lasting approximately 130 minutes, Fernandes et al found no significant changes in the biomarker [ 27 ], which suggests that short duration is a relevant factor.…”