실험견에서 상복강동맥 교차차단과 재개통 시 Nicardipine 투여가 전신 혈역학 및 신장 기능에 미치는 영향

Abstract

Background: The incidence of renal insufficiency is reported about 18 — 27% during the thoracoabdominal aneurysm surgery. The pc^sible mechanisms are reduction and maldistribution of renal blood flow, activation of renin angiotensin system, release of various mediators. In this study, we observed the effect of nicardipine, one of the calcium channel blockers that commonly used, on the systemic hemodynamics and the renal fuctions. Methods: A total of 13 mongrel dogs were divided into two groups: control group (C, n = 7)，nicardipine administration group (N, n = 6). After brachial arterial and Swan-Ganz catheterization, midline abdominal incision was made. For the aortic cross clamping the supraceilac aorta was exposed and the doppler flowmeter probe was placed on the left renal artery. The thermal diffusion microprobe was inserted in the renal parenchyme to measure local renal perfusion. At sixty minutes after aortic cross clamping, systemic hemodynamic data, renal blood flow and local renal perfusion were measured and at 1，2，3，4，5 and 6 hours after unclamping the same parameters were measured. Results: There were no differences on renal blood flow, renal perfusion and oxygen extraction ratio between two groups. The renal blood flow and renal perfusion did not recover to the baseline level after unclamping in both groups. The plasma renin activity, serum creatinine concentration and cystatin-c did not show any difference between groups respectively. Conclusions: We concluded that the administration of nicardipine after supraceliac aortic unclamping to improve the renal function was not effective in experimental dogs. (Korean J Anesthesiol 2004; 46: 467 — 474)