低血圧麻酔中の心房性利尿ホルモンとストレスホルモンの変動

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  • Changes in atrial natriuretic polypeptide and right atrial pressure during hypotensive anesthesia.

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We evaluated the relationship between the release of atrial natriuretic polypeptide (ANP) and right atrial pressure (RAP) in 15 orthopedic patients who underwent spinal surgery under hypotensive anesthesia. Mean arterial pressure was maintained within 60-70mmHg by either nitroglycerin (TNG), trimethaphan (TM) or prostaglangin E1 (PGE1). Increased levels of catecholamine, renin activity, angiotensin II, aldosterone and ADH were observed in patients when hypotension was induced with either TNG or PGE1.<br>However, in TM group, catecholamine levels were not elevated while other variables were increased during hypotension as TNG and PGE1. ANP was concomitantly decreased with reduction of RAP and elevated when RAP was restored to preanesthetic levels in three groups. Therefore, we conclude that the release of ANP is regulated by RAP and counteracted with the release of stress hormone during hypotensive anesthesia induced with either TNG, TM or PGE1.

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