Anesthesia, Renal Failure
Conditions
Brief summary
It is known that volatile anesthesia, such as sevoflurane, retain water and that this appears more pronounced in children. However, the mechanisms for this effect is unknown and it is not clear if the commonly used anesthetic propofol does the same. In this study the investigators want to compare the fluid and electrolyte conserving effects of sevoflurane and propofol in a pediatric setting and also investigate humoral changes induced by these anesthetics.
Detailed description
Prior studies by the investigators research group have shown water and sodium retention in experimental animals undergoing sevoflurane anesthesia. Preliminary data suggest that this is not as obvious with propofol anesthesia. The investigators aim to study if this difference is present in children. Subjects are collected from ordinary routine operations of hypospadia. By routine, all boys undergoing this surgery get a sacral blockade and a urine catheter. The children are randomized to either sevoflurane or propofol anesthesia. Before or immediately after induction of anesthesia baseline blood samples are collected for analysis of sodium, potassium, creatinine, osmolality, angiotensin II, arginine-vasopressin and aldosterone. Perioperative fluids are started, a balanced glucose infusion with 132mmol sodium content, covering basal fluid need + 20%. This infusion is continued until the end of the protocol at the ward. At the induction of anesthesia the investigators start measuring urine output every 20th minute. The same blood samples as above are collected again during mid-operation. At the end of anesthesia the investigators collect all the urine and send a sample for urine analysis of sodium, potassium, osmolality and creatinine. In the postoperative ward the investigators again start collecting urine every 20 minutes for 120 minutes. All urine after 120 minutes are collected, and a sample sent for analysis. After 60 minutes at the postoperative ward, blood samples are again collected for analysis. In the childrens ward the protocol for the postoperative ward is repeated, with urine collection and sample, as well as blood samples. After 120 minutes the protocol ends.
Interventions
DRUGSevoflurane
anesthetic agent
DRUGpropofol
anesthetic agent
Sponsors
Uppsala University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
BASIC_SCIENCE
Masking
NONE
Eligibility
Sex/Gender
MALE
Age
1 Years to 12 Years
Healthy volunteers
Yes
Inclusion criteria
* Eligible for hypospadia surgery.
Exclusion criteria
* American Association of Anesthesiology class above 2 * Weight above 50 kg or below 10 kg * Hypersensitivity towards the anesthetic agents (difficult peanut or soy allergy) * Inability for parent to understand study information
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| urine output during anesthesia | 2 hours |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| urine output postoperatively | 4 hours | — |
| sodium excretion postoperatively | 4 hours | — |
| Changes in aldosterone, angiotensin II, arginine-vasopressin during surgery | 2 hours | Comparison of blood samples of fluid balance regulatory hormones collected at baseline, during surgery and 1 hour + 3 hours postoperatively |
| Changes in aldosterone, angiotensin II, arginine-vasopressin postoperatively | 4 hours | Comparison of blood samples of fluid balance regulatory hormones collected at baseline, during surgery and 1 hour + 3 hours postoperatively |
| Sodium excretion during anesthesia | 2 hours | — |
Countries
Sweden
Outcome results
None listed