Sevoflurane, a volatile halogenated ether, has been widely used in the conduct of anesthesia. Its potency, easy titratability, less pungency and rapid recovery are the reasons for its pervasive use in clinical practice. However, it is not without adverse effects. The nephrotoxicity associated with its use has been the subject of dispute over the years. At present, no highly sensitive renal marker has been the subject of dispute over the years. At present, no highly sensitive renal marker has been utilized to assess renal function. Objective: To compare the effect on renal function as measured by nuclear glomerular filtration rate, serum creatinine, urine protein creatinine ratio, proteinuria and glocosuria of sevoflurane with isoflurane in patients undergoing donor nephrectomy. Study Design and Methods: A randomized comparative study of postoperative renal functions as measured by nuclear glomerular filtration rate, serum creatinine, urine protein creatinine ratio, proteinuria and glucosuria in patients undergoing donor nephrectomies who have received low flow (<1 L/Min) sevoflurane or isoflurane were done. Results: A total of 102 kidney donors met the inclusion criteria. Forty seven subjects (46%) were randomized to receive isoflurane while 55 received sevoflurane (54%). Most subjects were in the third decade of life. There was no statistically significant difference between the two groups in terms of the baseline clinical characteristics. Comparing between the two anesthetic groups, there was no significant difference in terms of serum creatinine, total GFR, nuclear GFR per kidney. There was a statistically higher proportion of patients with urine protein- creatinine ratios of 0.2 and above in the isoflurane group (64% versus 38%) while more patients in the sevoflurane group had ratios above 0.2 (62% versus 36%, p=.045). The type of anesthetic agent was not an independent predictor of increasing serum creatinine, total GFR and urine protein- creatinine ratio and nuclear GFR assessed per kidney. Conclusion: There were no statistical differences noted in measured renal function parameters among patients undergoing donor nephrectomy after low flow sevoflurane compared with isoflurane anesthesia. These results suggest that low flow sevoflurane is as safe as low flow isoflurane and does not alter renal functions in patients for donor nephrectomy.
Human ; SEVOFLURANE ; NEPHRECTOMY ; ANESTHESIA ; ISOFLURANE

Foreign body reactions after endovascular procedures for brain arteriovenous malformations are extremely rare. We report the case of a cerebral foreign body granuloma reaction after embolization of a frontal arteriovenous malformation with Onyx. A previously treated 36-year-old man underwent re-embolization of a residual and recurrent unruptured right frontal vascular malformation with Onyx. The post-procedural imaging revealed a right frontotemporal heterogeneously enhancing expansive lesion associated with a residual malformation. Following microsurgical resection, the histopathological examination of the expansive lesion revealed basophilic foreign body like deposits adjacent to multi-nucleated giant cells, highly compatible with cerebral foreign body granulomas reaction to Onyx. The clinical and radiological follow-up of the patient was favorable after complete resection of the lesions.