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首页> 外文期刊>Surgical Endoscopy >Effect of diltiazem on kidney function during laparoscopic surgery.
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Effect of diltiazem on kidney function during laparoscopic surgery.

机译：地尔硫卓对腹腔镜手术期间肾功能的影响。

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BACKGROUND: Pneumoperitoneum is known to be associated with transient impairment in kidney function. This study was designed to investigate the effect of diltiazem on acute kidney injury during positive pneumoperitoneum in patients undergoing laparoscopic surgery. METHODS: Thirty-two patients of American Society of Anesthesiologists (ASA) 1 and 2 physical status undergoing laparoscopic surgery were randomly divided into control (normal saline infusion) and diltiazem groups (diltiazem 2 microg/kg/min). Urinary flow, urinary sodium excretion, creatinine clearance (CrCl), and hemodynamic variables were determined during pneumoperitoneum and at postoperative 2 h. CrCl using Cockcroft-Gault equation was calculated before surgery (baseline), and at postoperative days 1 (POD1) and 2. RESULTS: The hemodynamic parameters were similar in both groups. CrCl during pneumoperitoneum in the diltiazem group was significantly higher than that in the control group (90.8 +/- 49.0 ml/min/1.73 m(2) vs. 54.2 +/- 31.6 ml/min/1.73 m(2)) (P = 0.026). CrCl calculated with Cockcroft-Gault equation was similar in both groups at baseline, POD1, and POD2. Urinary flow was significantly increased in both groups at postoperative 2 h compared with that during pneumoperitoneum. CONCLUSION: Continuous infusion of diltiazem 2 microg/kg/min prevented the decrease in CrCl during pneumoperitoneum without hemodynamic derangement. Although the decrease in CrCl was transient in patients with normal kidney function in this study, diltiazem may be used to prevent further kidney injury in those with elevated CrCl during laparoscopic surgery.
机译：背景：气腹已知与肾功能的短暂损害有关。本研究旨在研究地尔硫卓对腹腔镜手术患者正气腹期间急性肾损伤的影响。方法：将32例美国麻醉医师协会（ASA）1和2身体状况接受腹腔镜手术的患者随机分为对照组（正常生理盐水输注）和地尔硫卓组（地尔硫卓2 microg / kg / min）。在气腹期间和术后2 h确定尿流，尿钠排泄，肌酐清除率（CrCl）和血液动力学变量。使用Cockcroft-Gault方程计算CrCl的值是在手术前（基线）以及术后第1天（POD1）和第2天。结果：两组的血流动力学参数相似。地尔硫卓组气腹中的CrCl显着高于对照组（90.8 +/- 49.0 ml / min / 1.73 m（2）与54.2 +/- 31.6 ml / min / 1.73 m（2））（P = 0.026）。用Cockcroft-Gault方程计算的CrCl在基线，POD1和POD2两组均相似。与气腹期间相比，两组术后2小时尿流明显增加。结论：连续输注地尔硫卓2 microg / kg / min可防止气腹过程中CrCl的降低，而无血流动力学紊乱。尽管在这项研究中，肾功能正常的患者中CrCl的下降是短暂的，但在腹腔镜手术期间，地尔硫卓可用于防止CrCl升高的患者进一步的肾脏损伤。

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