Clinical Trial: Renal Function During Pediatric Anesthesia

Study Status: Recruiting
Recruit Status: Recruiting
Study Type: Interventional

Official Title: The Influence of Propofol and Sevoflurane Anesthesia on Water and Sodium Retention in Children

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 Summary:

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.


Sponsor: Uppsala University

Current Primary Outcome: urine output during anesthesia [ Time Frame: 2 hours ]

Original Primary Outcome: Same as current

Current Secondary Outcome:

  • urine output postoperatively [ Time Frame: 4 hours ]
  • sodium excretion postoperatively [ Time Frame: 4 hours ]
  • Changes in aldosterone, angiotensin II, arginine-vasopressin during surgery [ Time Frame: 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 [ Time Frame: 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 [ Time Frame: 2 hours ]


Original Secondary Outcome: Same as current

Information By: Uppsala University

Dates:
Date Received: October 5, 2015
Date Started: October 2015
Date Completion: December 2016
Last Updated: October 22, 2015
Last Verified: October 2015