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| Title | Epidural Analgesia Combined with a Small-Dose of Fentanyl Attenuates the Endocrine Responses and Renal Tubular Damage during Thoracotomy |
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| Authors | Seijiro Sonoda |
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| Authors(kana) | |
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| Organization | Department of Anesthesiology, Juntendo University, School of Medicine, Tokyo, Japan
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| Journal | Circulation Control |
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| Volume | 27 |
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| Number | 4 |
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| Page | 346-351 |
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| Year/Month | 2006/12 |
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| Article | 原著 |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | Abstract The purpose of this study is to investigate the hypothesis that epidural analgesia combined with fentanyl suppresses endocrine responses and prevents renal impairment during thoracotomy. Thirty patients undergoing elective lung lobectomy via thoracotomy were randomly divided into three groups according to the anesthetic method. The patients of group GA received only general anesthesia. Those in group CGE received general anesthesia and epidural analgesia with 1% mepivacaine. Those in group F received general anesthesia, epidural analgesia with 1% mepivacaine, and fentanyl given both intravenously and to the epidural space. Plasma cortisol and aldosterone were measured as indicators of the endocrine response. Urinary output of N-acetylbeta-D-glucosaminidase (NAG) was also measured as an indicator of renal tubular damage. In group F, NAG and cortisol releases were suppressed. NAG increased by 191% and by 119%, and cortisol increased by 247% and by 167% in group GA and CGE, respectively (p < 0. 05). In group F, the aldosterone release was attenuated down to 48% over the preoperative values, while it increased markedly by 358% and by 264%, in group GA and CGE, respectively. These results suggest that fentanyl in addition to epidural analgesia attenuates the endocrine responses and the renal tubular damage during thoracotomy. |
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| Practice | Basic medicine |
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| Keywords | epidural analgesia, fentanyl, endocrine responses, renal tubular damage, thoracotomy |
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