Evidence map›Paper›PMID 32812189›Full record

SynthesisCanadian journal of anaesthesia = Journal canadien d'anesthesie2020

The impact of sevoflurane anesthesia on postoperative renal function: a systematic review and meta-analysis of randomized-controlled trials.

Rakesh V Sondekoppam, Karim H Narsingani, Trent A Schimmel, Brie M McConnell, Karen Buro, Timur J-P Özelsel

Open access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 1 pooled it
2.7field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.

  1. Pooled it
  2. Environmental impact of anesthetic gases.Medical gas research · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 2 countries.

Rakesh V SondekoppamDepartment of Anesthesia, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
Karim H NarsinganiUniversity of Alberta Medical School, Edmonton, AB, Canada.
Trent A SchimmelUniversity of Alberta Medical School, Edmonton, AB, Canada.
Brie M McConnellSchulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Karen BuroDepartment of Mathematics and Statistics, MacEwan University, Edmonton, AB, Canada.
Timur J-P ÖzelselDepartment of Anesthesia and Pain Medicine, University of Alberta, 2-150 Clinical Sciences Building (CSB), 8440 112 St NW, Edmonton, AB, T6G 2G3, Canada. ozelsel@ualberta.ca.ORCID http://orcid.org/0000-0002-1780-0632
University of Alberta · CAMacEwan University · CAUniversity of Iowa · USWestern University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeRenal damage secondary to fluoride ions and compound A (CpdA) after sevoflurane anesthesia remains unclear. For safety reasons, some countries still recommend minimum fresh-gas flows (FGFs) with sevoflurane. We review the evidence regarding the intraoperative use of sevoflurane for anesthesia maintenance and postoperative renal function compared with other anesthetic agents used for anesthetic maintenance. Secondarily, we examine the effects of peak plasma fluoride and CpdA levels and the effect of FGF and duration of anesthesia on these parameters. SOURCE: The databases of MEDLINE (OVID and Pubmed), EMBASE, the Cochrane Library, Health Technology Assessment Database, CINAHL, and Web of Science were searched from inception until 23 April 2020 to identify randomized-controlled trials (RCTs) in humans utilizing sevoflurane or an alternative anesthetic for anesthesia maintenance with subsequent measurements of renal function. Two different paired reviewers independently selected the studies and extracted data. The quality of the evidence was appraised using GRADE recommendations. PRINCIPAL

findingsOf 3,766 publications screened, 41 RCTs in human patients were identified. There was no difference between creatinine at 24 hr (21 studies; n = 1,529), or creatinine clearance (CCR) at 24 hr (12 studies; n = 728) in the sevoflurane vs alternative anesthetic groups. Peak fluoride and fluoride measured at 24 hr were higher with sevoflurane compared with other inhaled anesthetics. Subgroup analyses for sevoflurane usage in various contexts showed no significant difference between sevoflurane and alternative anesthetics for creatinine or CCR at 24 hr at varying FGF, duration of exposure, baseline renal function, or absorbent use.

conclusionsWe did not find any association between the use of sevoflurane and postoperative renal impairment compared with other agents used for anesthesia maintenance. The scientific basis for recommending higher FGF with the use of sevoflurane needs to be revisited.

Indexed as

AnesthesiaAnesthetics, InhalationIsofluraneMethyl EthersEthersHumansRandomized Controlled Trials as TopicSevofluraneAnesthetics, InhalationEthersIsofluraneMethyl EthersSevofluranecompound Afluoride ionsfresh-gas flownephrotoxicitysevoflurane

Identifiers

PMID32812189
OpenAlexW3050529076

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.