Year : 2013 | Volume : 6 | Issue : 1 | Page : 84--89
Evaluation of the value of epidural anesthesia in improvement of renal functions in preeclamptic patients with early renal impairment
Bahaa El-Din Ewiss, Ayman M. Kamaly, Ahmed N. Al-Shaer, Amr Sobhy
Department of Anesthesiology, Intensive Care, and Pain Management, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
This study aimed to evaluate the value of epidural anesthesia in improving renal functions in preeclamptic patients with early renal impairment.Patients and methods
The study included 60 patients of ASA (American Society of Anesthesiologists) physical status II–III, age range 19–40 years, found to have mild preeclampsia with early renal impairment. The patients were divided randomly into two groups. Epidural anesthesia was administered in the epidural anesthesia (Epi) group (n=30), whereas patients in the control (Cont) group (n=30) were subjected to the same procedure for epidural catheter insertion, but not activated (except after the study time), and then treated by conventional measures according to the protocol of the Obstetric ICU of Ain Shams University Hospitals. For each patient, the following data were collected: hemodynamic changes, urine output, and renal function [detected by cystatin C, serum creatinine, blood urea nitrogen, and then estimation of glomerular filtration rate (GFR)].Results
There was a statistically significant reduction in blood pressure (systolic blood pressure, diastolic blood pressure, and mean arterial blood pressure) in the Epi group after 15 min of epidural activation on comparing subsequent measures with the baseline value (T
Performing a renal sympathetic block by epidural anesthesia helps improve renal function with better control of blood pressure in preeclamptic patients with an early renal impairment detected by the sensitive renal marker cystatin C.