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Surgical Endoscopy
Published in: Surgical Endoscopy 8/2009

01-08-2009

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

Published in: Surgical Endoscopy | Issue 8/2009

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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 μg/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 m2 vs. 54.2 ± 31.6 ml/min/1.73 m2) (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 μg/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.
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Metadata
Title
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
Publication date
01-08-2009
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 8/2009
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-008-0225-1

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