[The effect of epidural anesthesia with combined use of vasodilator on hemodynamics and stress hormone levels during hepatectomy].
The combined effects of thoracic epidural anesthesia and vasodilators on hemodynamics, stress responses, sodium excretion and liver function were investigated in eight patients who received hepatectomy. As vasodilators, phentolamine and/or prostaglandin E1 were chosen. Under these conditions, systemic vascular resistance decreased and cardiac index increased by afterload reduction. This hemodynamic changes were induced by sympathetic nerve blocking, vasodilator and hemodilution. The increase of epinephrine and norepinephrine levels were suppressed during the surgery and there were no significant changes in plasma renin activity, angiotensin II and aldosterone levels. Sodium excretion was maintained during the surgery. Arterial ketone body ratio did not decrease and lactic acid/pyrvate acid ratio showed low values. None of the patients developed respiratory complications nor liver failure after the surgery. Combined use of epidural anesthesia and vasodilators kept stable hemodynamics and suppressed endocrine stress responses. These were considered beneficial for liver function and sodium excretion during and after the hepatectomy.
Arai
M
M
Department of Anesthesiology, Kitasato University, School of Medicine, Sagamihara.
Nomiyama
S
S
Ozawa
A
A
D000759:Adjuvants, Anesthesia; D000328:Adult; D000368:Aged; D000527:Alprostadil; D000767:Anesthesia, Epidural; D004837:Epinephrine / Q000378:metabolism*; D005260:Female; D006439:Hemodynamics; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D007432:Intraoperative Period; D008099:Liver / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010646:Phentolamine; D012964:Sodium / Q000378:metabolism; D013312:Stress, Physiological / Q000503:physiopathology; D014665:Vasodilator Agents
D000759:Adjuvants, Anesthesia; D014665:Vasodilator Agents; D012964:Sodium; D000527:Alprostadil; D004837:Epinephrine; D010646:Phentolamine