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Related Experiment Videos

Renal function and stress response during halothane or fentanyl anesthesia

K Kono, D M Philbin, C H Coggins

    Anesthesia and Analgesia
    |August 1, 1981
    PubMed
    Summary

    High-dose fentanyl anesthesia attenuated hormonal stress and preserved renal function during coronary artery surgery. Halothane anesthesia, however, increased stress hormones and decreased renal function, suggesting hormonal changes impact kidney function.

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    Area of Science:

    • Anesthesiology
    • Cardiovascular Surgery
    • Renal Physiology
    • Endocrinology

    Background:

    • Anesthesia and surgical procedures can elicit a significant hormonal stress response.
    • This stress response may adversely affect renal function during major surgeries.
    • Understanding the impact of different anesthetic agents on this response is crucial for patient outcomes.

    Purpose of the Study:

    • To compare the effects of fentanyl- versus halothane-based anesthesia on hormonal stress response.
    • To evaluate the impact of these anesthetic regimens on renal function during coronary artery surgery.
    • To determine if anesthetic-induced hormonal changes correlate with alterations in renal function.

    Main Methods:

    • Two groups of patients undergoing elective coronary artery surgery were studied.

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  • Group 1 received high-dose fentanyl with N2O/O2; Group 2 received halothane with N2O/O2.
  • Plasma levels of vasopressin, renin, aldosterone, cortisol, epinephrine, and norepinephrine were measured, along with urine volume, osmolality, Na+, and creatinine clearance.

    • Main Results:

    • Fentanyl anesthesia (Group 1) showed no significant changes in vasopressin, renin, or aldosterone, but decreased cortisol, epinephrine, and norepinephrine.
    • Group 1 experienced increased urine volume and decreased urine osmolality and Na+, with unchanged creatinine clearance.
    • Halothane anesthesia (Group 2) resulted in increased cortisol, aldosterone, and vasopressin, accompanied by a significant decrease in creatinine clearance.

    Conclusions:

    • High-dose fentanyl anesthesia effectively attenuates the hormonal stress response to cardiopulmonary bypass and surgery.
    • Fentanyl anesthesia preserves renal function, indicated by stable creatinine clearance and changes in urine composition.
    • The study suggests that anesthesia-induced hormonal changes may contribute to the observed decreases in renal function during surgical stress.