title: General anesthesia type does not influence serum levels of neutrophil gelatinase-associated lipocalin during the perioperative period in video laparoscopic bariatric surgery.
abstract: OBJECTIVE
  Video laparoscopic bariatric surgery is the preferred surgical technique for treating morbid obesity. However, pneumoperitoneum can pose risks to the kidneys by causing a decrease in renal blood flow. Furthermore, as in other surgical procedures, laparoscopic bariatric surgery triggers an acute inflammatory response. Neutrophil gelatinase-associated lipocalin is an early and accurate biomarker of renal injury, as well as of the inflammatory response. Anesthetic drugs could offer some protection for the kidneys and could attenuate the acute inflammatory response from surgical trauma. The objective of this study was to compare the effects of two types of anesthetics, propofol and sevoflurane, on the serum levels of neutrophil gelatinase-associated lipocalin during the perioperative period in laparoscopic bariatric surgery.
  
  
  METHODS
  Sixty-four patients scheduled for laparoscopic bariatric surgery were randomized into two anesthesia groups and were administered either total intravenous anesthesia (propofol) or inhalation anesthesia (sevoflurane). In the perioperative period, blood samples were collected at three time points (before anesthesia, 6 hours after pneumoperitoneum and 24 hours after pneumoperitoneum) and urine output was measured for 24 hours. Acute kidney injuries were evaluated by examining both the clinical and laboratory parameters during the postoperative period. The differences between the groups were compared using non-parametric tests. ReBEC (http://www.ensaiosclinicos.gov.br/rg/recruiting/): RBR-8wt2fy
  
  
  RESULTS
  None of the patients developed an acute kidney injury during the study and no significant differences were found between the serum neutrophil gelatinase-associated lipocalin levels of the groups during the perioperative period.
  
  
  CONCLUSIONS
  The choice of anesthetic drug, either propofol or sevoflurane, did not affect the serum levels of neutrophil gelatinase-associated lipocalin during the perioperative period in laparoscopic bariatric surgery.
authors.affiliation: Department of Anesthesiology, São Rafael Hospital, Salvador, BA, Brazil.
authors.forename: Adriano
authors.initials: A
authors.lastname: Fernandes
authors.affiliation: Department of Surgery, São Rafael Hospital, Salvador, BA, Brazil.
authors.forename: João
authors.initials: J
authors.lastname: Ettinger
authors.affiliation: Department of Anesthesiology, São Rafael Hospital, Salvador, BA, Brazil.
authors.forename: Fabiano
authors.initials: F
authors.lastname: Amaral
authors.affiliation: Department of Anesthesiology, São Rafael Hospital, Salvador, BA, Brazil.
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Ramalho
authors.affiliation: Department of Anesthesiology, São Rafael Hospital, Salvador, BA, Brazil.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Alves
authors.affiliation: Anesthesiology, Department of Botucatu Medical School, Universidade Estadual Paulista (UNESP), Botucatu, SP, Brazil.
authors.forename: Norma Sueli Pinheiro
authors.initials: NS
authors.lastname: Módolo
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology; D000209:Acute-Phase Proteins; D000328:Adult; D000768:Anesthesia, General / Q000009:adverse effects / Q000379:methods; D000771:Anesthesia, Intravenous; D018685:Anesthetics, Inhalation / Q000494:pharmacology*; D018686:Anesthetics, Intravenous / Q000494:pharmacology*; D050110:Bariatric Surgery / Q000009:adverse effects / Q000379:methods*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood*; D008297:Male; D008738:Methyl Ethers / Q000494:pharmacology*; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery; D059035:Perioperative Period; D015742:Propofol / Q000494:pharmacology*; D011518:Proto-Oncogene Proteins / Q000097:blood*; D012307:Risk Factors; D000077149:Sevoflurane; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome; D020535:Video-Assisted Surgery / Q000009:adverse effects / Q000379:methods*
chemical_list: D000209:Acute-Phase Proteins; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D008738:Methyl Ethers; D011518:Proto-Oncogene Proteins; D000077149:Sevoflurane; D015742:Propofol