[Evaluation of the renal function during hypotensive anesthesia induced by nitroglycerin, prostaglandin E1 or nitroglycerin+prostaglandin E1].

We investigated the renal function perioperatively in 32 female patients who underwent mastectomy with hypotensive general anesthesia induced by nitroglycerin (NG), prostaglandin E1 (PGE1) and NG+PGE1. Urine output in PGE1 group (11 patients) was significantly larger than that in NG group (9 patients). It could be attributed to the increase of glomerular filtration rate. On the other hand, the value of beta 2-microglobulin in urine in NG group and the value of N-acetyl-beta-D-glucosaminidase in urine in NG+PGE1 group (12 patient) were abnormal in some patients. These changes were not significant, but the disturbance of renal tubule could be possible. In summary, PGE1 was effective in the maintenance of the renal function.

Sympathetic influence on alveolar surface activity in hyperventilated dog.

Hyperventilating IPPB, defined as intermittent positive-pressure breathing with a frequency of 32 beats/min and inspiratory pressure of 30 cmH2O, was administered for 14 h to open-chested anesthetized dogs in which nerves to one bronchus were operatively blocked. In the nerve-intact lungs, the lung stability index calculated from the pressure-volume relationship decreased with the duration of the hyperventilating IPPB (correlation coefficient r = -0.66, P less than 0.001), and atelectasis and hemorrhage appeared. In the nerve-blocked lungs, the index did not decrease during the 14 h of hyperventilating IPPB, and the appearance was almost normal. After pharmacologic sympathetic block with phenoxybenzamine, the lung stability index of both the operatively nerve-blocked lung and the nerve-intact lung was not decreased by hyperventilating IPPB. From these findings, we conclude that sympathetic block can protect pulmonary surface activity from the adverse effects of hyperventilating IPPB.