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Anesth Analg 1977; 56:102-109
© 1977 International Anesthesia Research Society
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Changing Renal Blood Flow Following Sodium Nitroprusside in Patients Undergoing Nephrolithotomy

ALEXANDER A. BIRCH, MD*, and WILLIAM H. BOYCE, MD{dagger}

* Associate Professor, Department of Anesthesia., North Carolina Baptist Hospital; Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina 27103. {dagger} Professor, Department of Urology., North Carolina Baptist Hospital; Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina 27103.

Abstract

During nephrolithotomy in 23 adult patients under sodium thiopental-N2O-O2-fentanyl anesthesia, renal blood flow to one kidney was studied. Muscle relaxation was obtained with pancuronium, and renal blood flow (RBF) was measured with an electromagnetic flow probe. Percutaneous arterial pressures were also recorded. Administration of sodium nitroprus-side caused a decrease in RBF in all patients when mean arterial pressure (MAP) was reduced approximately 44 percent below baseline. Patients whose initial RBF was below 300 ml/min showed greater falls in RBF with hypotension. Changes in renal vascular resistance (MAP/RBF) was found to be markedly higher in the "low-flow" group. As expected, the low-flow group started with a higher renal vascular resistance.

From these observations, it is felt that more concern should be exercised when planning deliberate hypotension with nitroprusside, especially in patients with decreased renal function.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 1977 by the International Anesthesia Research Society.