Perioperative medicine & outcomes
The association between volatile anaesthetic exposure and postoperative complications following bariatric surgery: A multicentre retrospective cohort study
Authors' conclusion
Cumulative volatile anaesthetic exposure was independently associated with increased postoperative complications following bariatric surgery. The association with reoperation rate appears to be a class effect, while sevoflurane, but not isoflurane, is associated with an increased risk of AKI.
Study context
- Population
- Patients undergoing laparoscopic bariatric procedures at four Israeli centres (January 2017-May 2025)included in final analysis
- Participants
- 16,685 patients
- Exposure
- Cumulative volatile anaesthetic exposure; sevoflurane vs isoflurane
- Outcome
- Reoperation (within 30 days) and AKI (within 7 days)
Methodological detailsmulticentre, mixed-effects logistic regression
- Multicentre
- Mixed-effects logistic regression
Main finding
As reported in the abstract
Reoperation and AKI per higher total MAChr exposure
Higher total MAChr exposureOdds ratio (95 % CI)P value
Reoperation
1.75(1.35–2.26)
P < 0.001AKI
1.35(1.05–1.70)
P = 0.015Per higher total MAChr exposure, as printed
Patients
- Reoperation
- 122 (0.7 %)
- Acute kidney injury (AKI)
- 96 (0.6 %)
Observational data: associations, not effects.
Further findings
AKI by agent
| OR (95 % CI) | P value | ||
|---|---|---|---|
| Sevoflurane | 1.53 (1.20–1.90) | P < 0.001 | |
| Isoflurane | 0.89 (0.55–1.38) | P = 0.630 | |
| 0.512Odds ratio (log scale) |
| Outcome | P value |
|---|---|
| AKI by agentSevoflurane vs Isoflurane | P = 0.012 |
Reoperation by agent
- Isoflurane and sevoflurane showed comparable associations with reoperation risk
Original publication
The association between volatile anaesthetic exposure and postoperative complications following bariatric surgery: A multicentre retrospective cohort study. J Clin Anesth. Published 7 October 2025. doi:10.
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