title: Comparison of Rhabdomyolysis Markers in Patients Undergoing Bariatric Surgery with Propofol and Inhalation-based Anesthesia.
abstract: BACKGROUND
  Rhabdomyolysis is a relatively uncommon, severe complication of anesthesia and surgery in the morbidly obese. As the use of propofol-based anesthesia has been associated with an increased risk of rhabdomyolysis and metabolic acidosis, this pilot study was designed to assess the effect of propofol anesthesia on the incidence of rhabdomyolysis in morbidly obese patients undergoing bariatric surgery.
  
  
  METHODS
  Thirty, morbidly obese patients (body mass index 43 ± 3 kg/m(2)) scheduled for bariatric laparoscopic sleeve gastrectomy were randomized to receive either propofol (P) or inhalational anesthetic (I)-based balanced general anesthesia. A sample of venous blood gas analysis including pH, bicarbonate concentrations, and calculated base excess was taken at the end of the operation. Creatine phosphokinase (CPK), troponin I, blood urea nitrogen, and creatinine plasma concentrations were measured at the end of the surgery and again 24 h later.
  
  
  RESULTS
  All patients enrolled to the study completed it without significant complications. CPK, troponin I, blood urea nitrogen, and creatinine plasma concentrations at the end of the operation and at 24 h, as well as the bicarbonate concentration and the base excess at the end of the operation were not significantly different between the two study groups. A statistically significant mild respiratory acidosis was noted in the inhalational anesthetic group (pH 7.30 ± 0.04 vs. 7.36 ± 0.02 in the propofol group)
  
  
  CONCLUSIONS
  This small-size pilot study may suggest that propofol-based anesthesia is not related to increased incidence of rhabdomyolysis in morbidly obese patients undergoing short, uncomplicated bariatric surgery.
authors.affiliation: Department of Anesthesiology, Rambam Healthcare Campus, Haifa, Israel, amit.lehavi@gmail.com.
authors.forename: Amit
authors.initials: A
authors.lastname: Lehavi
authors.forename: Olga
authors.initials: O
authors.lastname: Sandler
authors.forename: Ahmad
authors.initials: A
authors.lastname: Mahajna
authors.forename: Abraham
authors.initials: A
authors.lastname: Weissman
authors.forename: Yeshayahu Shai
authors.initials: YS
authors.lastname: Katz
mesh_terms: D000328:Adult; D000769:Anesthesia, Inhalation / Q000009:adverse effects*; D018686:Anesthetics, Intravenous / Q000009:adverse effects*; D050110:Bariatric Surgery / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood* / Q000150:complications / Q000601:surgery; D010865:Pilot Projects; D015742:Propofol / Q000009:adverse effects*; D012206:Rhabdomyolysis / Q000097:blood* / Q000139:chemically induced
chemical_list: D018686:Anesthetics, Intravenous; D015415:Biomarkers; D015742:Propofol