Naoya Iguchi1, Junko Kosaka2, Lindsea C Booth2, Yoko Iguchi3, Roger G Evans4, Rinaldo Bellomo5, Clive N May2, Yugeesh R Lankadeva6. 1. Preclinical Critical Care Unit, Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia; Department of Intensive Care, Austin Hospital, Melbourne, Victoria, Australia; Department of Anaesthesiology and Intensive Care Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan. 2. Preclinical Critical Care Unit, Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia. 3. Preclinical Critical Care Unit, Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia; Department of Intensive Care, Austin Hospital, Melbourne, Victoria, Australia; Department of Anaesthesiology, Saiseikai Senri Hospital, Osaka, Japan. 4. Cardiovascular Disease Program, Biomedicine Discovery Institute and Department of Physiology, Monash University, Melbourne, Victoria, Australia. 5. School of Medicine, University of Melbourne, Melbourne, Victoria, Australia. 6. Preclinical Critical Care Unit, Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia. Electronic address: yugeesh.lankadeva@florey.edu.au.
Abstract
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 (RDO2), 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)%], RDO2 [-76 (83-71)%], and cortical [-68 (74-54)%] and medullary [-76 (84-72)%] perfusion. I.V. anaesthesia reduced RBF [-55 (67-38)%], RDO2 [-55 (65-44)%], and cortical [-27 (45-6)%] and medullary [-35 (48-30)%] perfusion, but to a lesser extent than volatile anaesthesia. Renal PO2 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, RDO2, 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.
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 (RDO2), 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)%], RDO2 [-76 (83-71)%], and cortical [-68 (74-54)%] and medullary [-76 (84-72)%] perfusion. I.V. anaesthesia reduced RBF [-55 (67-38)%], RDO2 [-55 (65-44)%], and cortical [-27 (45-6)%] and medullary [-35 (48-30)%] perfusion, but to a lesser extent than volatile anaesthesia. Renal PO2 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, RDO2, 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.
Authors: Roger G Evans; Naoya Iguchi; Andrew D Cochrane; Bruno Marino; Sally G Hood; Rinaldo Bellomo; Peter R McCall; Clive N May; Yugeesh R Lankadeva Journal: Am J Physiol Regul Integr Comp Physiol Date: 2019-12-11 Impact factor: 3.619
Authors: Gregory M T Hare; Melina P Cazorla-Bak; S F Michelle Ku; Kyle Chin; Nikhil Mistry; Michael C Sklar; Katerina Pavenski; Ahmad Alli; Adriaan Van Rensburg; Jan O Friedrich; Andrew J Baker; C David Mazer Journal: Can J Anaesth Date: 2020-08-07 Impact factor: 6.713
Authors: Micael Taavo; Mats Rundgren; Peter Frykholm; Anders Larsson; Stephanie Franzén; Karin Vargmar; Jean F Valarcher; Gerald F DiBona; Robert Frithiof Journal: Function (Oxf) Date: 2021-08-20