Liver and renal functions following total intravenous anesthesia using midazolam and fentanyl—comparison with enflurane-nitrous oxide anesthesia

Abstract

Thirty patients undergoing lower abdominal surgery were studied to compare liver and renal functions in total intravenous anesthesia (TIVA) using midazolam and fentanyl with those in enflurane-nitrous oxide anesthesia (GOE).Patients were randomly divided into two groups of 15. In the TIVA group, anesthesia was induced with 0.3 mg·kg(-1) midazolam and maintained with 0.68 mg·kg(-1)·h(-1) midazolam for 15 min followed by 0.125 mg·kg(-1)·h(-1) midazolam and fentanyl. In the GOE group, anesthesia was induced with 5 mg·kg(-1) thiamylal and maintained with enflurane-nitrous oxide in oxygen. Plasma levels of aspartate aminotransferase, alanine aminotransferase (ALT), lactate dehydrogenase, total bilirubin, alkaline phosphatase, γ-glutamyl transpeptidase (γ-GTP), blood urea nitrogen (BUN), and creatinine (Cr) were measured before and at 1, 7, and 30 days after surgery. There were transient increases beyond the normal range in ALT and γ-GTP in both groups. BUN and Cr were within the normal range. There were no differences between the two groups regarding these parameters and the numbers with abnormally high levels of each parameter. In conclusion, liver and renal functions following TIVA using midazolam and fentanyl were the same as those following enflurane-nitrous oxide anesthesia.

Postoperative Liver and Kidney Function Following Total Intravenous Anesthesia: A Randomized Controlled Trial

“…Potential reasons for hepatic injuries with propofol administration may be secondary to an immunologic mechanism, disturbance of the mitochondrial respiratory chain in the hepatocytes, or reduced cytochrome C oxidase activity [21,22]. On the other hand, our findings are in some measures in accordance and in some in contrast with results of Nishiyama et al [23]. The authors showed transient increase more than the normal ranges in ALT and γ-glutamyltranspeptidase following TIVA with midazolam and fentanyl whereas BUN and creatinine remained in the normal limits.…”