The effect of low-dose prostaglandin E1 on intra- and post-operative renal function
Hayashida, M.; Hanaoka, K.; Shimada, Y.; Namiki, A.; Amaha, K.
Masui. Japanese Journal of Anesthesiology 46(4): 464-470
1997
ISSN/ISBN: 0021-4892 PMID: 9128016 Document Number: 471538
We investigated the effects of low-dose prostaglandin E-1 (PGE-1) on intra- and post-operative renal function in 109 adult patients undergoing upper abdominal surgery. Anesthesia was maintained with a combination of thoracic epidural combined with inhalational anesthesia. Sixty-seven patients received PGE-1 at a rate of 0.02 mu-g cntdot kg-1 cntdot min-1 throughout surgery. Forty-two patients, who did not receive PGE-1, served as control. Pre- and postoperative renal function was evaluated with serum levels of BUN and creatinine (Cr), while intraoperative renal function was evaluated mainly with urine output and urine flow rate during anesthesia. Urinary Na excretion and creatinine clearance (Ccr) were determined during surgery in limited cases. Urine output and urine flow rate during anesthesia were greater in PGE-1 group than in control group, whereas infusion volumes and infusion rates were not different between the groups. In PGE-1 group, urine flow rate was greater during surgery than before surgery, while in control group, it was unchanged. Na excretion during anesthesia was also greater in PGE-1 group than in control group. In control group, Na excretion and Ccr were smaller during surgery than before surgery, while in PGE-1 group, they were unchanged. Postoperative serum BUN and creatinine levels were not different between the groups. Decreased Na excretion and decreased Ccr in control group indicated that renal function was depressed during surgery, whereas unchanged Ccr, unchanged Na excretion and increased urine flow rate in PGE-1 group indicated that renal function was well-maintained during surgery with PGE-1. Low-dose PGE-1 thus prevented depression of renal function during surgical anesthesia.