The influence of low flow anaesthesia on renal function in cancer patients previously treated with nephrotoxic chemotherapeutic agents

Background
The aim of this study was to assess renal morbidity, associated with the use of low flow anaesthesia (LFA), in cancer patients previously treated with nephrotoxic chemotherapeutic agents.

Methods
Seventy-five patients, aged 30–70 years, scheduled for elective surgery, were randomly allocated to three groups: Group A included those patients who had received nephrotoxic chemotherapeutic agents (cisplatin, carboplatin, methotrexate or cyclophosphamide) within 90 days before surgery, and who were anaesthetised with low flow (0.8–1 L min–1) air-oxygen-sevoflurane (1–3 MAC) anaesthesia; Group B included similar patients who received high flow (6 L min–1) anaesthesia. Non-cancer patients receiving low flow anaesthesia served as controls. Blood was sampled for serum creatinine, BUN, cistatin C, and electrolytes (Na+, K+, Cl–, Ca2+, P3+, Mg2+) before anaesthesia, and one, three and five days after.

Results
There were no statistically significant differences between the groups.

Conclusions
The use of low flow sevoflurane anaesthesia is not associated with an increased risk of nephrotoxicity in those previously exposed to nephrotoxic chemotherapeutic agents.