Suppression of surgical hyperaldosteronism by potassium canrenoate during gynecologic surgery under sevoflurane anesthesia.
BACKGROUND
Surgical hyperaldosteronism leads to sodium and water retention during surgery and often causes postoperative edema. This study investigated the effect of potassium canrenoate (PC) on pituitary adrenocortical function in lower abdominal surgery under sevoflurane anesthesia.


METHODS
Twenty patients were randomized to receive 400 mg of PC (the PC group, n=10) or saline (the control group, n=10) intravenously. The following parameters were determined: plasma aldosterone, adrenocorticotropic hormone (ACTH), plasma renin activity (PRA), serum sodium and potassium, urinary sodium and potassium, and urine output.


RESULTS
The aldosterone and ACTH levels showed significant increases in the control group during surgery. Plasma ACTH also increased significantly in the PC group, but plasma aldosterone levels were unchanged during surgery. The urine Na/K ratio of the PC group was significantly higher than that of the control group.


CONCLUSIONS
The present study suggested that PC suppresses the increase of plasma aldosterone caused by surgical stress. That may prevent sodium retention and potassium excretion during surgery.
Watanabe
T
T
Department of Anesthesiology, Nippon Medical School, Tokyo, Japan. eban-w/anesth@nms.ac.jp
Ogawa
R
R
D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D000450:Aldosterone / Q000097:blood; D000769:Anesthesia, Inhalation; D018685:Anesthetics, Inhalation; D001794:Blood Pressure / Q000187:drug effects; D002191:Canrenoic Acid / Q000627:therapeutic use*; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D006929:Hyperaldosteronism / Q000517:prevention & control*; D007431:Intraoperative Complications / Q000517:prevention & control*; D008297:Male; D008738:Methyl Ethers; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use*; D011188:Potassium / Q000097:blood / Q000652:urine; D012083:Renin / Q000097:blood; D000077149:Sevoflurane; D012964:Sodium / Q000097:blood / Q000652:urine
D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000451:Mineralocorticoid Receptor Antagonists; D000077149:Sevoflurane; D000450:Aldosterone; D002191:Canrenoic Acid; D000324:Adrenocorticotropic Hormone; D012964:Sodium; D012083:Renin; D011188:Potassium