J.Jpn. Surg. Soc.. 56(3): 348-358, 1955
A STUDY OF RENAL FUNCTION DURING ANESTHESIA AND OPERATION
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Department of Surgery, Branch Hospital of Tokyo University Hospital (Director: Assist. Prof. Takeo HAYASHIDA) Mikio NAKAJIMA |
Chapter one is devoted mainly to the study of the management of patient under intratracheal anesthesia, and renal functional assaies of sixty two patients were performed and the urinary volume, aciduria, glucosuria, and alubuminuria, etc. were studied.
In chapter two, the measurements of acid excretion, ammoniatitratable acid ratio, urea excretion and PSP loading were made in sixty one patients whose majority underwent thoracic surgery and the relation of the renal function to acidosis was studied during the operation.
The results of assaies and studies as to renal function in both of the chapters described above are summarized as follows;
1. Prior to intratraheal anesthesia and surgery, premedication only was sufficient enough to result in decrement of urinary output, and the tendency of water retention in the body increased considerably during anesthesia and operation.
2. In a few of the observed cases, anuria was detected lasting from sixty to eighty minutes and in another two cases, hemoglobinuria was found through intubation and attributed to the side-effect of myanesin which was administered for the intubation.
3. Albuminuria was already found to be present during endotracheal anesthesia before operation and glucosuria was recognized in almost all cases during the operation. Increment of blood sugar level, development of glucosuria and alubuminuria as well as the decrement of urinary output, and changes of blood and urinary electrolytes metabolism, were constructed as a vital protectional reaction which is responsible in the pituitary-adrenal system.
4. Remarkable decrement of urinary pH, increase of titratable acidity and ammonia concentratation in urine resulted from operations procedure and these caused an increase of urinary acid excretion.
These findings disclosed acidosis during anesthesia and operation as well as survey of the blood gas did.
5. Ammonia titratable acid ratio revealed a very low value and in a majority of cases, PSP excretion were disturbed during the anesthesia and operation. These suggest some degree of renal tubuli hypofunction will be expected from anesthesia and surgery.
6. In thoracic surgery, these changes were more prominent under endotracheal anesthesia than under local anesthesia, however, even when combined with thoracotomy, these changes were relatively slight in surgery of oesophagus and stomach.
(author's abstract)
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