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Effect of diltiazem on kidney function during laparoscopic surgery

Authors
 Ji Young Kim  ;  Kyung Cheon Lee  ;  Hong Soon Kim  ;  Youn Yi Jo  ;  Hyun Jeong Kwak 
Citation
 SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol.23(8) : 1785-1790, 2009 
Journal Title
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
ISSN
 0930-2794 
Issue Date
2009
MeSH
Aged ; Creatinine/blood ; Diltiazem/pharmacology* ; Female ; Humans ; Kidney/drug effects* ; Kidney/physiopathology ; Laparoscopy/methods* ; Male ; Metabolic Clearance Rate/drug effects ; Middle Aged ; Natriuresis/drug effects ; Natriuresis/physiology ; Pneumoperitoneum, Artificial/adverse effects*
Keywords
Pneumoperitoneum ; Diltiazem ; Kidney function
Abstract
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
Full Text
http://link.springer.com/article/10.1007%2Fs00464-008-0225-1
DOI
10.1007/s00464-008-0225-1
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Ji Young(김지영) ORCID logo https://orcid.org/0000-0001-5822-0338
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/104466
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