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Published on: June 25, 2013
[Remifentanil increases urine output in patients undergoing laparoscopic colectomy]
Ko Ishikawa1, Akira Sakai, Hirofumi Nagata
1Department of Anesthesiology, School of Medicine, Iwate Medical University, Morioka 020-8505.
Background:
It has been reported that laparoscopic surgery increases stress response such as oliguria. We investigated whether anesthetic methods affect urine output during anesthesia in patients undergoing laparoscopic colectomy.
Methods:
Urine output during anesthesia was compared retrospectively between general anesthesia with intravenous infusion of remifentanil, without epidural anesthesia and general anesthesia combined with epidural anesthesia, without remifentanil. Patients were excluded if they had renal failure and/or had received diuretics. 331 American Society of Anesthesiologists (ASA) physical status 1-3 patients who had undergone elective laparoscopic colectomy were enrolled in the study (remifentanil group; n = 214, epidural group; n = 117). In addition, remifentanil group was divided into two groups (higher dose group; n = 108, lower dose group; n = 106) with the median value of 0.3 g x kg(-1) x min(-1).
Results:
Urine output during anesthesia in remifentanil group was significantly higher than epidural group, although the volume of fluid infusion was significantly less in remifentanil group. Furthermore, urine output in higher dose remifentanil group was significantly higher than the lower dose group, while there were no significant differences in the volume of fluid infusion between the two groups.
Conclusions:
Adequate remifentanil injection might increase urine output by preventing stress response to laparoscopic colectomy.
