Saudi Journal of Anaesthesia

ORIGINAL ARTICLE
Year
: 2015  |  Volume : 9  |  Issue : 3  |  Page : 272--278

Effectiveness of intravenous infusion of N-acetylcysteine in cirrhotic patients undergoing major abdominal surgeries


Eman Sayed Ibrahim1, Ahmed Sharawy2 
1 Department of Anesthesia, National Liver Institute, Menofeya University, Menofeya, Egypt
2 Department of Clinical Pathology, National Liver Institute, Menofeya University, Menofeya, Egypt

Correspondence Address:
Dr. Eman Sayed Ibrahim
18 Hassan Abdel Latif, Maleka, Fesal, Giza
Egypt

Background: Postoperative acute kidney injury (AKI) is common in patients with chronic liver disease. We prospectively evaluated effectiveness of the N-acetylcysteine (NAC) in preserving postoperative renal functions in cirrhotic patients undergoing major abdominal surgeries. Materials and Methods: A total of 60 cirrhotic patients child A to B were randomized into two groups of 30 each.NAC groupwas received intravenous infusion of NAC (1200 mg/12h starting immediately before surgery and continued for 72h h postoperative) and controls group received a similar volume of glucose 5% solution as a a placebo. Systemic hemodynamics, hepatic and renal functions, serum cystatin C and cystatin C glomerular filtration rate (GFR) (GFR) were compared between both groups. Results: Serum level of cystatin C was raised significantly above the basal value at postoperative day 1 and day 3 associated with significantly decreased in cystatin C GFR below the basal value in the control group (P = 0.001). 6 (20%) (PP = 0.03) in control group developed AKI based on cystatin C GFR criteria (GFR <55 ml/min/1.73m 2 ). Mean values of alanine aminotransferase and aspartate aminotransferase were increased significantly above the basal values in both groups, but the increases were significantly lower in NAC group (P = 0.00). Chest infection was significantly lower associated with shorter hospital stay in the NAC group than the control group. Conclusion: Intravenous administration of NAC NAC in cirrhotic patients undergoing major abdominal surgeries reduces the incidence of cystatin C GFR-based AKI, postoperative renal and liver functions were well-preserved and improved outcome.


How to cite this article:
Ibrahim ES, Sharawy A. Effectiveness of intravenous infusion of N-acetylcysteine in cirrhotic patients undergoing major abdominal surgeries.Saudi J Anaesth 2015;9:272-278


How to cite this URL:
Ibrahim ES, Sharawy A. Effectiveness of intravenous infusion of N-acetylcysteine in cirrhotic patients undergoing major abdominal surgeries. Saudi J Anaesth [serial online] 2015 [cited 2022 Nov 29 ];9:272-278
Available from: https://www.saudija.org/article.asp?issn=1658-354X;year=2015;volume=9;issue=3;spage=272;epage=278;aulast=Ibrahim;type=0