A comparison of the effects of ketamine and remifentanil on renal functions in coronary artery bypass graft surgery

Figures & data

Figure 1. Anesthetic regimens and management.

Table 1. Patient characteristics, preoperative medication, euroscore II and cardiac profile data.

Parameter	RPM group (n = 19)	KPM group (n = 18)	p Values
Age (year) (mean ± SD)	61 ± 6.9	59 ± 8.7	0.329
Height (cm) (mean ± SD)	164 ± 8.3	166 ± 8.8	0.587
Weight (kg)(mean ± SD)	76 ± 11.5	79 ± 12.6	0.335
BMI (kgm^−2)
(median, min–max)	28.1 (22–35)	28.7 (22–36)	0.455
Gender (M/F)	11/8	15/3	0.091
EF (%) (median)	55	55	0.413
EuroScore II  (median, min–max)	0.98 (0.6–2.2)	0.75 (0.5–2.2)	0.06
DM (n)	8	6	0.582
HT (n)	12	12	0.07
COPD (n)	3	6	0.486
Β-blocker (n)	19	18	0.752
ACE inhibitors (n)	14	10	0.138
Ca blockers (n)	2	2	1
Nitrates (n)	16	18	0.693
Diuertics (n)	3	3	0.98
Statins (n)	12	11	0.898
ASAII/III (n)	8/11	10/8	0.516

Notes: RPM: remifentanil–propofol–midazolam; KPM: ketamine–propofol–midazolam, BMI: body mass index; EF: ejection fraction; DM: diabetes mellitus; HT: hipertension; COPD: cronic obstructive pulmonary disease.

Table 2. Intraoperative data, 28 day mortality.

Parameter	RPM group (n = 19)	KPM group (n = 18)	p Values
AoX duration (min) (median)	54 (13–80)	51 (31–97)	0.641
CPB duration (min) (median)	97 (70–124)	94 (74–115)	0.711
Anesthesia duration (h)  (median)	3.5 (2–5)	3 (3–5)	0.258
RBC (units) (median)	1 (0–2)	1 (0–2)	0.620
FFP (patients of given 1 U)	6	6	0.909
Vessels (n) (median)	3 (1–4)	3 (1–5)	0.960
28 day mortality (n)	0	0	–

Notes: RPM: remifentanil–propofol–midazolam; KPM: ketamine–propofol–midazolam, AoX: aortic cross clemp; CPB: cardiopulmonary bypass; RBC: red blood cell; FFP: fresh frozen plasma.

Figure 2. Urea levels (mg dL⁻¹) are presented as box plots for each group and time point. Note: For remifentanil group: urea 2–4 p < 0.01, urea 3–4 p < 0.05, urea 4–5 p < 0.001. For group KPM: urea 2–4 p < 0.05, urea 3–4 p < 0.05.

Figure 3. Creatinine levels (mg dL⁻¹) are presented as box plots for each group and time point. Note: Both for groups Creatinine 1–4 p < 0.05, Creatinine 2–4 p < 0.001.

Figure 4. Cystatin-C levels (mg L⁻¹) are presented as box plots for each group and time point. Note: For remifentanil group: Cystatin-C 1–4 p < 0.001, Cystatin-C 2–4 p < 0.001, Cystatin-C 3–4 p < 0.01. For ketamine group: Cystatin-C 1–4 p < 0.01, Cystatin-C 2–4 p < 0.001, Cystatin-C 3–4 p < 0.001, Cystatin-C 4–5 p < 0.01.

Figure 5. Hs-troponin T levels (ng/L) are presented as box plots for each group and time point. Note: Both for groups: Hs-troponin T 1–2 p < 0.001, Hs-troponin T 1–3 p < 0.001, Hs-troponin T 1–4 p < 0.001, Hs-troponin T 1–5 p < 0.05, Hs-troponin T 3–5 p < 0.001.

Table 3. Data of the patients with stage 1 AKI in postoperative day 2.

Patients	Age(year)/ Sex (M/F)	DM/ HT	Baseline Cr	Postop. 2.day Cr	Baseline Cys-C	Postop. 2.day Cys-C	Preop. Hct%	Xklemp time	RBC Transf Unit	Preop. statin	Euroscore II
RPM 2	60/M	−/−	0.78	1.10	0.71	1.15	38.8	68	1	+	0.55
RPM 3	55/M	−/−	0.73	1	0.84	1.2	43.8	80	–	+	0.55
RPM 10	66/M	−/−	1.14	1.64	0.99	1.35	38.1	54	–	−	0.66
RPM 11	68/F	+/+	0.62	1.05	0.79	1.29	44.1	38	–	−	1.23
RPM 12	68/F	−/+	0.82	1.21	0.91	1.2	33.8	58	1	+	0.87
RPM 13	66/M	+/+	0.92	1.52	0.88	1.31	36.3	55	1	+	1.28
RPM 19	55/M	−/−	0.72	1.53	0.95	1.15	42.3	51	1	+	0.55
KPM 5	62/M	−/−	0.86	1.12	1.1	1.4	41	97	2	+	0.71
KPM 7	47/M	−/+	0.85	1.38	0.9	1.22	44.8	41	1	−	0.55
KPM 8	51/M	+/−	1.65	2.42	1.5	2.10	36.1	45	–	+	0.79
KPM 9	65/M	−/+	0.69	1.24	0.9	1.13	39.4	52	–	+	0.64
KPM 14	58/M	+/−	0.91	1.26	0.95	1.16	33	45	–	+	1.3
KPM 15	57/M	−/−	1.1	2.29	1.22	1.95	45	60	–	+	0.55

Notes: RPM: remifentanil–propofol–midazolam; KPM: ketamine–propofol–midazolam. DM: diabetes mellitus; HT: hipertension; Postop: postoperative; Preop: preoperative; Hct: hematocrit; RBC: red blood cell; Cr: creatinin; Cys-C: Cystatin-C.