Brazilian Journal of Anesthesiology
https://app.periodikos.com.br/journal/rba/article/doi/10.1590/S0034-70942003000600008
Brazilian Journal of Anesthesiology
Scientific Article

Efeitos do halotano, isoflurano e sevoflurano sobre a função renal em cães sob pinçamento aórtico infra-renal

Effects of halothane, isoflurane and sevoflurane on renal function in dogs under infra-renal aortic cross-clamping

Flora Margarida Barra Bisinotto; José Reinaldo Cerqueira Braz

http://dx.doi.org/10.1590/S0034-70942003000600008 Braz J Anesthesiol, vol.53, n6, p.767-783, 2003
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Resumo

JUSTIFICATIVA E OBJETIVOS: O pinçamento infra-renal da aorta abdominal pode produzir alterações renais. O objetivo do estudo foi avaliar os efeitos do halotano, isoflurano e sevoflurano sobre a função renal, em cães submetidos a pinçamento aórtico infra-renal. MÉTODO: O estudo aleatório foi realizado em 30 cães, distribuídos em três grupos, de acordo com o anestésico halogenado utilizado durante a anestesia, em concentrações equipotentes de 0,75 CAM: GH (n = 10) - halotano a 0,67%; GI (n = 10) - isoflurano a 0,96%; e GS (n = 10) - sevoflurano a 1,8%. Em todos os animais foi realizada ligadura infra-renal da aorta, por período de 30 minutos. Os atributos renais foram estudados nos momentos: C (controle), após 15 (Ao15) e 30 (Ao30) minutos de pinçamento aórtico, e após 15 (DAo15) e 30 (DAo30) minutos do despinçamento aórtico. RESULTADOS: A depuração de água livre foi menor nos grupos GI e GS, em relação ao GH, após o despinçamento aórtico (p < 0,05). Durante o pinçamento aórtico, nos três grupos, houve aumento do débito urinário, da excreção urinária de sódio e da depuração de sódio, e diminuição da osmolaridade urinária (p < 0,05). A resistência vascular renal e a fração de filtração aumentaram somente em GS (p < 0,05), enquanto a excreção fracionária de sódio aumentou em GH e GI (p < 0,05). Após o despinçamento aórtico, houve normalização dos atributos que haviam se alterado, com exceção da osmolaridade urinária, que continuou em níveis menores do que os do controle em todos os grupos (p < 0,05). A resistência vascular renal e a fração de filtração continuaram mais elevadas em GS, acompanhadas por diminuição do fluxo sangüíneo renal e da depuração de para-aminohipurato de sódio (p < 0,05). CONCLUSÕES: No cão nas condições experimentais empregadas, a inalação de halotano e isoflurano a 0,75 CAM, mas não de sevoflurano, atenuou a principal alteração após o pinçamento infra-renal da aorta, que é o aumento da resistência vascular renal.

Palavras-chave

ANESTÉSICOS, ANESTÉSICOS, ANESTÉSICOS, ANESTÉSICOS, ANIMAL, CIRURGIA, CIRURGIA

Abstract

BACKGROUND AND OBJECTIVES: Infra-renal aortic cross-clamping is associated to renal effects. This study aimed at analyzing halothane, isoflurane and sevoflurane effects on renal function of dogs submitted to infra-renal aortic cross-clamping. METHODS: This study involved 30 mixed-breed dogs randomly distributed in three groups, according to equipotent anesthetic doses (0.75 MAC) of inhaled anesthetics: GH (n = 10) - 0.67% halothane; GI (n = 10) - 0.96% isoflurane; and GS (n = 10) - 1.8% sevoflurane. All animals were submitted to infra-renal aortic cross-clamping for 30 minutes. Renal parameters were evaluated at control (C), 15 (Ao15) and (Ao30) minutes after aortic cross-clamping, and 15 (DAo15) and 30 (DAo30) minutes after aortic unclamping. RESULTS: Free water clearance was significantly lower in GI and GS as compared to GH (p < 0.05) after aortic unclamping. Urinary output, sodium urinary excretion and sodium clearance have significantly increased during aortic cross-clamping, while urinary osmolarity has decreased in all groups (p < 0.05). Renal vascular resistance and filtration fraction have increased during aortic cross-clamping in GS only, while sodium fractional excretion increased in GH and GI (p < 0.05). All renal parameters had returned to control levels after aortic unclamping, with the exception of urinary osmolality which has remained below control levels in all groups (p < 0.05). Renal vascular resistance and filtration fraction have remained higher in GS, followed by renal blood flow and PAH clearance decrease (p < 0.05). CONCLUSIONS: In dogs under our experimental conditions, 0.75 MAC of halothane or isoflurane, but not 0.75 MAC of sevoflurane, have minimized renal vascular resistance increase, which is the major infra-renal aortic cross-clamping effect.

Keywords

ANESTHETICS, ANESTHETICS, ANESTHETICS, ANESTHETICS, ANIMAL, SURGERY, SURGERY

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