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Trimethaphan-induced hypotension: effect on renal function

R Behnia, A Martin, E Koushanpour

    Canadian Anaesthetists' Society Journal
    |November 1, 1982
    PubMed
    Summary
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    Trimethaphan-induced hypotension during surgery temporarily reduced kidney function, specifically creatinine clearance and sodium reabsorption. However, renal tissue oxygenation remained adequate, and function returned to normal post-surgery.

    Area of Science:

    • Nephrology
    • Anesthesiology
    • Surgical Physiology

    Background:

    • Controlled hypotension is used in surgery to reduce blood loss and improve visibility.
    • The effects of trimethaphan, an antihypertensive agent, on renal function during surgery are not fully understood.
    • Previous research suggests sodium nitroprusside-induced hypotension has similar effects on renal function.

    Purpose of the Study:

    • To evaluate the impact of trimethaphan-induced hypotension on renal function in young, healthy patients undergoing maxillofacial surgery.
    • To compare the renal effects of trimethaphan-induced hypotension with previously reported sodium nitroprusside effects.

    Main Methods:

    • A within-subject design was employed, with each patient serving as their own control.
    • Trimethaphan was infused to achieve a mean arterial pressure of approximately 49 torr during surgery.

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  • Measurements included endogenous creatinine clearance, urinary Po2, sodium reabsorption rate (Tna), and serum/urine osmolalities before, during, and after hypotension.

    • Main Results:

    • A significant decrease (p<0.05) in endogenous creatinine clearance and Tna was observed during trimethaphan-induced hypotension.
    • These renal function parameters returned to baseline levels within one hour after discontinuing trimethaphan.
    • No significant changes were found in urine Po2, serum osmolality, or urine osmolality during the hypotensive period.

    Conclusions:

    • Trimethaphan-induced hypotension temporarily impairs renal function, specifically creatinine clearance and sodium reabsorption, in healthy young patients.
    • Medullary renal tissue oxygenation appears to remain adequate, suggesting tissue viability is preserved.
    • The renal effects of trimethaphan-induced hypotension are comparable to those of sodium nitroprusside-induced hypotension.