Health Care : Current Reviews

THE POTENTIAL RENAL PROTECTIVE EFFECT OF INTRAVENOUS DEXMEDETOMIDINE FOR PATIENTS DURING RADICAL CYSTECTOMY

Joint Event on 2^nd International Conference on Healthcare & Hospital Management and 6^th International Conference on Medical & Nursing Education

November 6-7, 2017 | Vienna, Austria

Mohamed AbdelFattah, Golinar E H Ahmed, M Harraz and Mahmoud M Othman

Mansoura University, Egypt

Posters & Accepted Abstracts: Health Care Current Reviews

Abstract:

Statement of the Problem: Peri-operative AKI accounts for 20â??25% of cases of hospital-acquired kidney injury. Careful and thoughtful preoperative assessment, including identifying patients with existing chronic kidney disease and avoiding nephrotoxic medications may reduce the incidence of peri-operative AKI (Acute Kidney Injury). Prospective human studies establishing a renal protective effect of dexmedetomidine are still questionable. Purpose: The purpose of this study is to test the hypothesis that intra-operative intravenous dexmedetomidine infusion could improve early renal function after open radical cystectomy. Methodology & Theoretical Orientation: This randomized comparative study was carried out on 100 patients of either sex, ASA I and II with baseline serum creatinine below 1.4 mg/dl who were submitted for radical cystectomy. The patients were randomly allocated into two groups according to the drug infused intra-operatively; dexmedetomidine group and fentanyl group. Dexmedetomidine group: received loading dose (0.8μg/kg) over 20 minutes, followed by intravenous infusion (0.4μg/kg/h) and fentanyl group: received loading dose (1μg/kg), followed by intravenous infusion (1μg/kg/h) during intra-operative period till end of procedure. Assessment of renal function through evaluation of preoperative estimated glomerular filtration rate (eGFR) using Modification of Diet in Renal Disease (MDRD) formula based on baseline serum creatinine, serum cystatin C level at 24 hours post-operative, daily post-operative serum creatinine for one-week post-operative and postoperative eGFR using MDRD formula. Findings: This study showed that post-operative renal function was similar to pre-operative values in both groups and no statistically significant renal protective effect of dexmedetomidine could be detected. Conclusion & Significance: Intra-operative infusion of dexmedetomidine has no statistically significant â??reno protectiveâ?? effect in the early postoperative period after radical cystectomy up to one-week post-operative as evaluated by serum creatinine, eGFR and serum cystatin C level.