Haemodynamic, diuretic and hormonal responses to prostaglandin E1, infusion in halothane anaesthetized dogs: comparison among epidural lidocaine, epidural fentanyl and epidural saline

Hiroshi Yamaguchi, Izumi Harukuni, Hiroshi Naito

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Deliberate hypotension decreases blood loss and transfusion but it may be accompanied by adverse effects due either to the hypotensive agents themselves or to haemodynamic alterations. Prostaglandin E1 (PGE1) has the advantage of a diuretic effect coupled with systemic hypotension. To elucidate the mechanisms by which PGE1 induces diuresis we compared the haemodynamic, diuretic and hormonal responses to PGE1 infusion simultaneously with epidural lidocaine (EP-L n = 7), epidural fentanyl (EP-F n = 8) or epidural saline (CONT n = 7) in halothane anaesthetized mongrel dogs. All groups developed a decrease in mean arterial pressure during PGE1 infusion (from 105 ± 24 to 77 ± 18 mmHg in EP-L; 106 ± 19 to 79 ± 13 mmHg in the EP-F; and 129 ± 14 to 106 ± 18 mmHg in the CONT groups (mean ± SD)) (P < 0.05). In the EP-F and CONT groups urinary output increased during PGE1 infusion (from 4.31 ± 1.89 to 6.15 ± 2.03 ml · min-1 and 2.71 ± 1.23 to 4.48 ± 1.66 ml · min-1 (P < 0.05), respectively) and was accompanied by increases in renal blood flow (from 87.0 ± 40.7 to 111.0 ± 42.8 ml · min-1 and from 121.6 ± 46.6 to 158.4 ± 64.9 ml · min-1 (P < 0.05), respectively) and in fractional excretion of sodium (FENa) (from 4.78 ± 3.88 to 7.63 ± 5.20% in CONT group). Plasma epinephrine concentration increased after laparotomy in the CONT group (from 0.09 ± 0.08 to 0.17 ± 0.14 pg · min-1) (P < 0.05) and antidiuretic hormone (ADH) concentration increased after laparotomy (from 6.9 ± 5.2 to 21.0 ± 13.0 pg · ml-1 in EP-F and from 8.1 ± 6.2 to 45.8 ± 29.9 pg · ml-1 in CONT groups). Plasma renin activity increased after laparotomy in the EP-L group (from 2.00 ± 1.37 to 4.72 ± 2.73 mg · ml-1 hr-1) (P < 0.05). The results suggest that the mechansim of the PGE1- induced diuretic effect includes increases in renal blood flow while renal sympathetic innervation is maintained and in FENa in the presence of elevated plasma ADH concentration.

Original languageEnglish (US)
Pages (from-to)425-433
Number of pages9
JournalCanadian Journal of Anaesthesia
Volume42
Issue number5
DOIs
StatePublished - May 1 1995

Keywords

  • anaesthetic techniques: epidural fentanyl, epidural lidocaine, hypotension
  • hormones: antidiuretic, catecholamines, plasma renin activity, prostaglandins
  • kidney: diuresis

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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