The effects of prolonged controlled hypotension induced by prostaglandin E1 on renal tubular function.

The effects of the prolonged 3-hour and 6-hour controlled hypotension induced by prostaglandin E1 (PGE1) on renal tubular function have been comparatively studied with trimethaphan (TMP; 3-hour hypotensive anesthesia) and enflurane deep anesthesia (6-hour hypotensive anesthesia), using the urine N-acetyl-β-D-glucosaminidase (NAG index) and the serum and urine N-acetyl-β-D-glucosaminidase (fractional clearance ofβ 2-m; Fc-β 2-m) as markers. During 3-hour and 6-hour controlled hypotension PGE1 , NAG index and Fc-β 2-m and urine volume could be maintained without remarkable changes. In the group with TPM, NAG index and Fc-β 2-m significantly increased. The increasing trend was also noted over time in deep anesthesia with enflurane. On 1st postoperative day, Fc-β 2-m significantly increased in PGE1 group in both 3-hour and 6-hour hypotensive anesthesia, whereas it restored to normal on 2nd postoperative day. Also, in TMP and enflurane deep anesthesia, Fc-β 2-m significantly increased on 1st postoperative day. With the latter, significant increase was also observed on 2nd postoperative day. These results suggest that, in 3-hour and 6-hour controlled hypotension induced by PGE1 , renal tubular function is normally maintained and that it is useful for prolonged controlled hypotensive anesthesia. However, further study is necessary because tubular dysfunction might appear on 1st postoperative day.