A comparative study on effects of propofol and sevoflurane on renal ischemia reperfusion injury after abdominal aortic aneurysm repair

Objective To compare the effects of propofol and sevoflurane on renal ischemia reperfusion injury after abdominal aortic aneurysm repair. Methods A total of 108 patients receiving elective infrarenal abdominal aortic aneurysm repair in Second People's Hospital of Shanxi Province from December 2014 to June 2016 were chosen as the subjects in this study, and randomly divided into group A and B with 54 patients in each group. Patients in group A received propofol anesthesia and those in group B received sevoflurane anesthesia. Kidney specific urinary proteins (NGAL, α1-M, GST-pi and GST-α) and plasma inflammatory cytokines (TNF-and IL-1β) were measured within 5 min after starting anesthesia (T0), at the end of surgery(T1), and at 8 h(T2), 16 h(T3) and 24 h(T4) after surgery. Serum creatinine, cystatin C and 24-hour urine output were measured at the baseline and at 1d, 3d and 6d after surgery. Results At T1, the NGAL, α1-M, GST-pi and GST-α level in both groups reached to the highest values, and then tended to reduce. However, the protein level in group A was significantly lower than that in group B, such as NGAL value (1.01±0.38) vs (1.24±0.34) ng/mL at T1, with P=0.03. Changes in serum creatinine, cystatin C and 24-hour urine output were similar to urinary protein, i.e. the levels of serum creatinine, cystatin C and 24-hour urine output after surgery in group A were notably lower than that in group B (P<0.05). The plasma proinflammatory cytokine levels in both groups increased over time, but even at different points the TNF-α and IL-1β in group A were lower than those in group B, such as TNF-α level (213±49) vs (366±40) ng/L at T4, with P=0.04. Conclusions Propofol can significantly reduce the severity of renal ischemia reperfusion injury after abdominal aortic aneurysm repair.