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Effects of sodium nitroprusside-induced controlled hypotension on pancreatic function assessed by pancreatitis-associated protein in patients undergoing radical prostatectomy

Published online by Cambridge University Press:  16 August 2006

S. N. Piper
Affiliation:
Klinikum Ludwigshafen, Department of Anaesthesiology and Intensive Care Medicine, Ludwigshafen, Germa
S. W. Suttner
Affiliation:
Klinikum Ludwigshafen, Department of Anaesthesiology and Intensive Care Medicine, Ludwigshafen, Germa
W. H. Maleck
Affiliation:
Klinikum Ludwigshafen, Department of Anaesthesiology and Intensive Care Medicine, Ludwigshafen, Germa
B. Kumle
Affiliation:
Klinikum Ludwigshafen, Department of Anaesthesiology and Intensive Care Medicine, Ludwigshafen, Germa
G. Haisch
Affiliation:
Klinikum Ludwigshafen, Department of Anaesthesiology and Intensive Care Medicine, Ludwigshafen, Germa
J. Boldt
Affiliation:
Klinikum Ludwigshafen, Department of Anaesthesiology and Intensive Care Medicine, Ludwigshafen, Germa
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Abstract

Background and objective: Controlled hypotension may alter organ blood flow and tissue oxygenation. The aim of the study was to investigate whether induced hypotension using sodium nitroprusside alters pancreatic function assessed by pancreatitis-associated protein concentrations in the blood.

Methods: Thirty patients undergoing elective radical prostatectomy were allocated randomly into two groups: (a) hypotension group: sodium nitroprusside was administered to lower mean arterial pressure to approximately 50 mmHg; (b) control group: no hypotension was used, mean arterial pressure was kept >70 mmHg. Pancreatitis-associated protein and lipase were measured in arterial blood samples: after induction of anaesthesia (T1), at the end of surgery (T2), 2 h (T3) and 24 h (T4) postoperatively.

Results: Pancreatitis-associated protein plasma concentrations increased significantly in patients in the hypotensive group (from 2.8 ± 1.1 to 5.5 ± 2.0 µg L−1 at T4) and pancreatitis-associated protein plasma concentrations were significantly higher in comparison with controls (5.5 ± 2.0 versus 3.5 ± 2.4 µg L−1) at T4. Lipase concentrations showed a similar course in both groups. None of the patients showed clinical signs of pancreatitis.

Conclusions: Controlled hypotension during surgery was associated with a small but significant increase in pancreatitis-associated protein compared with controls. The absence of concomitant elevation in lipase concentrations and a lack of clinical evidence of pancreatitis damage suggest that hypotension induces mild pancreatic stress.

Type
Original Article
Copyright
2002 European Society of Anaesthesiology

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