title: Effects of atrial natriuretic peptide at a low dose on water and electrolyte metabolism during general anesthesia.
abstract: OBJECTIVE
  To assess the hemodynamic, renal, and endocrine effects of small continuous doses of atrial natriuretic peptide (ANP) in patients anesthetized with sevoflurane for gastrectomy.
  
  
  METHODS
  Prospective randomized study.
  
  
  METHODS
  Operating room and wards of a university hospital.
  
  
  METHODS
  20 ASA physical status I and II patients scheduled for gastrectomy.
  
  
  METHODS
  Atrial natriuretic peptide (0.05 microg/kg/min; ANP group, n = 10) or saline (control group, n = 10) was infused continuously for 2 hours beginning at the start of the operation.
  
  
  METHODS
  Plasma concentrations of ANP, brain natriuretic peptide, cortisol, angiotensin II, and aldosterone; plasma renin activity; serum and urinary sodium, potassium, and chloride; and urinar output.
  
  
  RESULTS
  The ANP group showed much greater urine volume and sodium, potassium, and chloride excretion than the control group, although the ANP group had a lower arterial blood pressure. The infusion did not affect surgery-induced increases in hormones. No patients experienced excessive hypotension, bradycardia, or other perioperative complications.
  
  
  CONCLUSIONS
  Continuous intravenous infusion of ANP at 0.05 microg/kg/min during gastrectomy was associated with greater water and electrolyte excretion unaccompanied by changes in potentially interacting hormones. Low-dose infusion may be particularly safe and useful for controlling water and electrolyte metabolism intraoperatively.
authors.affiliation: Department of Anesthesiology, Nippon Medical School, Tokyo 113-8603, Japan.
authors.forename: Mariko
authors.initials: M
authors.lastname: Koda
authors.forename: Atsuhiro
authors.initials: A
authors.lastname: Sakamoto
authors.forename: Ryo
authors.initials: R
authors.lastname: Ogawa
mesh_terms: D000368:Aged; D000450:Aldosterone / Q000097:blood; D000768:Anesthesia, General; D018685:Anesthetics, Inhalation; D000804:Angiotensin II / Q000097:blood; D009320:Atrial Natriuretic Factor / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005743:Gastrectomy; D006439:Hemodynamics / Q000187:drug effects; D006728:Hormones / Q000097:blood; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007262:Infusions, Intravenous; D008297:Male; D008738:Methyl Ethers; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D012083:Renin / Q000097:blood; D000077149:Sevoflurane; D014563:Urodynamics / Q000187:drug effects; D014667:Vasopressins / Q000097:blood; D014882:Water-Electrolyte Balance / Q000187:drug effects*
chemical_list: D018685:Anesthetics, Inhalation; D006728:Hormones; D008738:Methyl Ethers; D014667:Vasopressins; D000804:Angiotensin II; D020097:Natriuretic Peptide, Brain; D000077149:Sevoflurane; D000450:Aldosterone; D009320:Atrial Natriuretic Factor; D012083:Renin; D006854:Hydrocortisone