Lumbar Epidural Anesthesia for Percutaneous Nephrostolithotomy in a Woman With Pseudo-Bartter Syndrome: Case Report

Background and Objectives. Pseudo-Bartter syndrome, which mimics Bartter syndrome, is a disorder characterized by a normal or low arterial blood pressure, despite markedly elevated plasma renin activity, angiotensin II, and aldosterone, as well as hypokalemic metabolic alkalosis. Changes of the cardiovascular and renin-angiotensin-aldosterone systems in response to epidural anesthesia and surgery in patients with pseudo-Bartter syndrome have yet to be clearly elucidated. Methods. A 35-year-old woman with this syndrome underwent a percutaneous nephrostolithotomy under lumbar epidural anesthesia with intravenous sedation. Results and Conclusions. During anesthesia and surgery, no profound hemodynamic derangements were observed, though the levels of plasma renin activity and angiotensin II decreased to almost half that of the preanesthetic values.