Evaluation of renal resistive index in patients undergoing arthroscopic shoulder surgery with controlled hypotension.
- 1Department of Anesthesiology and Reanimation, Ankara Etlik City Hospital, Ankara, Türkiye. [email protected].
- 2Department of Anesthesiology and Reanimation, Ankara Etlik City Hospital, Ankara, Türkiye.
Abstract
Background
Controlled hypotension is a widely adopted anesthetic method in shoulder arthroscopy to improve visual clarity. However, hypotension-related hypoperfusion may lead to postoperative acute kidney injury (AKI). The renal resistive index (RRI) is considered an effective and reliable parameter for identifying prerenal AKI. This study aimed to evaluate perioperative changes in RRI during shoulder arthroscopy with controlled hypotension.Methods
Following ethics committee approval, 90 adult patients undergoing elective shoulder arthroscopy were prospectively assessed. Controlled hypotension was achieved by adjusting the intravenous remifentanil infusion (0.01-0.2 µg/kg/min). RRI was measured pre- and postoperatively in pain-free, hemodynamically and respiratory stable patients. AKI was defined according to the Kidney Disease: Improving Global Outcomes criteria.Results
Data from 65 patients were analyzed. The postoperative RRI values (mean ± SD: 0.683 ± 0.085) were significantly higher than the preoperative values (mean ± SD: 0.648 ± 0.077) (p < 0.001). The mean change in RRI (delta RRI), calculated as (postoperative RRI - preoperative RRI) / preoperative RRI, was 5.6%. Stage I AKI was observed in 3 patients (4.6%). Preoperative RRI showed a positive correlation with both age and Simple Postoperative AKI Risk (SPARK) score, and a negative correlation with baseline glomerular filtration rate. Postoperative RRI showed a positive correlation with age.Conclusions
The observed increase in RRI suggests that controlled hypotensive anesthesia during shoulder arthroscopy may affect renal perfusion. Perioperative RRI assessment may therefore serve as a tool to evaluate renal perfusion changes.Trial registration
ClinicalTrials.gov, TRN: NCT05945706, Registration date: 07 May 2023.
Related
- Continuous intra-arterial versus noninvasive blood pressure monitoring for preventing hypotension during anesthesia induction in patients aged ≥ 75 years undergoing noncardiac surgery: a randomized controlled trial.
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- Development and Internal Validation of a Preintubation Prediction Model for Postintubation Hypotension in Trauma Patients Undergoing Emergency Endotracheal Intubation: A Retrospective Cohort Study
- Frailty and intraoperative hypotension in older adults undergoing hip fracture surgery: a retrospective cohort study.
- Effect of Hand Grip Exercise on Rotator Cuff Strength and Shoulder Function Recovery after Arthroscopic Rotator Cuff Repair: A Prospective Randomized Controlled Trial
BibTeX
@article{sipahioglu2026evaluation,
title = {{Evaluation of renal resistive index in patients undergoing arthroscopic shoulder surgery with controlled hypotension.}},
author = {Fatma Ozkan Sipahioglu and Funda Atar and Merve Bayraktaroglu and Filiz Karaca Akaslan and Derya Ozkan},
journal = {BMC anesthesiology},
year = {2026},
month = aug,
doi = {10.1186/s12871-026-04196-x},
url = {https://europepmc.org/article/MED/42972515},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Evaluation of renal resistive index in patients undergoing arthroscopic shoulder surgery with controlled hypotension.
AU - Fatma Ozkan Sipahioglu
AU - Funda Atar
AU - Merve Bayraktaroglu
AU - Filiz Karaca Akaslan
AU - Derya Ozkan
PY - 2026
DA - 2026/08/28
JO - BMC anesthesiology
DO - 10.1186/s12871-026-04196-x
UR - https://europepmc.org/article/MED/42972515
AB - Background Controlled hypotension is a widely adopted anesthetic method in shoulder arthroscopy to improve visual clarity. However, hypotension-related hypoperfusion may lead to postoperative acute kidney injury (AKI). The renal resistive index (RRI) is considered an effective and reliable parameter for identifying prerenal AKI. This study aimed to evaluate perioperative changes in RRI during shoulder arthroscopy with controlled hypotension.Methods Following ethics committee approval, 90 adult patients undergoing elective shoulder arthroscopy were prospectively assessed. Controlled hypotension was achieved by adjusting the intravenous remifentanil infusion (0.01-0.2 µg/kg/min). RRI was measured pre- and postoperatively in pain-free, hemodynamically and respiratory stable patients. AKI was defined according to the Kidney Disease: Improving Global Outcomes criteria.Results Data from 65 patients were analyzed. The postoperative RRI values (mean ± SD: 0.683 ± 0.085) were significantly higher than the preoperative values (mean ± SD: 0.648 ± 0.077) (p < 0.001). The mean change in RRI (delta RRI), calculated as (postoperative RRI - preoperative RRI) / preoperative RRI, was 5.6%. Stage I AKI was observed in 3 patients (4.6%). Preoperative RRI showed a positive correlation with both age and Simple Postoperative AKI Risk (SPARK) score, and a negative correlation with baseline glomerular filtration rate. Postoperative RRI showed a positive correlation with age.Conclusions The observed increase in RRI suggests that controlled hypotensive anesthesia during shoulder arthroscopy may affect renal perfusion. Perioperative RRI assessment may therefore serve as a tool to evaluate renal perfusion changes.Trial registration ClinicalTrials.gov, TRN: NCT05945706, Registration date: 07 May 2023.
SN - 1471-2253
ER -