TY - JOUR
T1 - Renal perfusion, oxygenation, and sympathetic nerve activity during volatile or intravenous general anaesthesia in sheep
AU - Iguchi, Naoya
AU - Kosaka, Junko
AU - Booth, Lindsea C.
AU - Iguchi, Yoko
AU - Evans, Roger G.
AU - Bellomo, Rinaldo
AU - May, Clive N.
AU - Lankadeva, Yugeesh R.
N1 - Funding Information:
National Health and Medical Research Council of Australia ( 1050672 to CNM and RGE ); Victorian Government Operational Infrastructure Support Grant; National Heart Foundation of Australia Future Leader Fellowship ( 101853 to YRL); Early Career Medical Research Grant from the Jack Brockhoff Foundation ( 4178 to YRL).
Publisher Copyright:
© 2018 British Journal of Anaesthesia
PY - 2019/3
Y1 - 2019/3
N2 - Background: Global and intra-renal perfusion and oxygenation may be affected by the choice of anaesthetic. We compared the effects of isoflurane with those of propofol and fentanyl on renal blood flow (RBF) and intra-renal perfusion and oxygenation, and assessed how these were associated with renal sympathetic nerve activity (RSNA). Methods: A renal artery flow probe and laser Doppler and oxygen-sensing probes were surgically implanted in the renal medulla and cortex in 20 Merino ewes. RSNA was measured in 12 additional ewes. We compared the effects of volatile or i.v. anaesthesia on global RBF, renal oxygen delivery (RDO 2 ), intra-renal perfusion, and RSNA with the non-anaesthetised state on postoperative day 3 as control reference. Results: Compared with a non-anaesthetised state, volatile anaesthesia reduced global RBF [–76 (82–68)%], RDO 2 [−76 (83–71)%], and cortical [–68 (74–54)%] and medullary [–76 (84–72)%] perfusion. I.V. anaesthesia reduced RBF [–55 (67–38)%], RDO 2 [–55 (65–44)%], and cortical [–27 (45–6)%] and medullary [–35 (48–30)%] perfusion, but to a lesser extent than volatile anaesthesia. Renal PO 2 was not influenced by anaesthesia, whilst RSNA was elevated during volatile, but not during i.v. anaesthesia. Conclusions: Volatile and i.v. general anaesthesia markedly reduced global RBF, RDO 2 , and regional kidney perfusion. These effects were greater with volatile anaesthesia, and were paralleled by an increase in RSNA. Our findings suggest a neurogenic modulatory effect of anaesthetics on renal perfusion and oxygenation.
AB - Background: Global and intra-renal perfusion and oxygenation may be affected by the choice of anaesthetic. We compared the effects of isoflurane with those of propofol and fentanyl on renal blood flow (RBF) and intra-renal perfusion and oxygenation, and assessed how these were associated with renal sympathetic nerve activity (RSNA). Methods: A renal artery flow probe and laser Doppler and oxygen-sensing probes were surgically implanted in the renal medulla and cortex in 20 Merino ewes. RSNA was measured in 12 additional ewes. We compared the effects of volatile or i.v. anaesthesia on global RBF, renal oxygen delivery (RDO 2 ), intra-renal perfusion, and RSNA with the non-anaesthetised state on postoperative day 3 as control reference. Results: Compared with a non-anaesthetised state, volatile anaesthesia reduced global RBF [–76 (82–68)%], RDO 2 [−76 (83–71)%], and cortical [–68 (74–54)%] and medullary [–76 (84–72)%] perfusion. I.V. anaesthesia reduced RBF [–55 (67–38)%], RDO 2 [–55 (65–44)%], and cortical [–27 (45–6)%] and medullary [–35 (48–30)%] perfusion, but to a lesser extent than volatile anaesthesia. Renal PO 2 was not influenced by anaesthesia, whilst RSNA was elevated during volatile, but not during i.v. anaesthesia. Conclusions: Volatile and i.v. general anaesthesia markedly reduced global RBF, RDO 2 , and regional kidney perfusion. These effects were greater with volatile anaesthesia, and were paralleled by an increase in RSNA. Our findings suggest a neurogenic modulatory effect of anaesthetics on renal perfusion and oxygenation.
KW - fentanyl
KW - i.v. anaesthesia
KW - isoflurane
KW - propofol
KW - renal blood flow
KW - renal perfusion
KW - renal sympathetic nerve activity
KW - volatile anaesthesia
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U2 - 10.1016/j.bja.2018.11.018
DO - 10.1016/j.bja.2018.11.018
M3 - Article
C2 - 30770052
AN - SCOPUS:85059682610
VL - 122
SP - 342
EP - 349
JO - British Journal of Anaesthesia
JF - British Journal of Anaesthesia
SN - 0007-0912
IS - 3
ER -