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간절제술 중 nitroglycerin을 이용한 저중심정맥압 유지기법 시 저용량 dopamine 투여에 의한 신기능 변화

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Author(s)
유진균장영호김진모김애라강구정
Keimyung Author(s)
Jang, Young HoKim, Jin MoKim, Ae RaKang, Koo Jeong
Department
Dept. of Anesthesiology & Pain Medicine (마취통증의학)
Dept. of Surgery (외과학)
Journal Title
대한마취과학화지
Issued Date
2004
Volume
47
Issue
6
Abstract
Background: The maintenance of low central venous pressure (LCVP) induced by fluid restriction and nitroglycerin
administration reduces the overall blood loss during major hepatic resections. We studied the postoperative renal function in
hepatectomized patients under LCVP maintenance with nitroglycerin. In addition, the renal effect of low dose dopamine combined
with nitroglycerin was evaluated.
Methods: A total of 60 patients were randomly divided into two groups: a nitroglycerin group (n = 30), and a nitroglycerin
and dopamine group (n = 30). During the Pringle maneuver the central venous pressure (CVP) was maintained at < 5 mmHg
in both groups. The nitroglycerin group received 0.5-1μg/kg/min nitroglycerin before and during the Pringle maneuver, but
in nitroglycerin and dopamine group, 3μg/kg/min dopamine was administered with nitroglycerin. Mean arterial pressure, CVP,
and urine output were measured before, during, and after the Pringle maneuver. BUN and serum creatinine were measured on
postoperative days 1 and 3.
Results: No significant differences were observed between the mean arterial pressures, CVPs, or urine outputs of the two groups.
In both groups, urine output reduced after the Pringle maneuver but increased more in the nitroglycerin and dopamine group
than in the nitroglycerin control group after anesthesia. There was no overall statistical change in either BUN or creatinine in
either group.
Conclusions: We conclude that LCVP induced by nitroglycerin with the Pringle maneuver during hepatectomy does not cause
postoperative renal dysfunction, and that the use of low dose dopamine with nitroglycerin has no meaning in terms of preventing
renal dysfunction in this situation. (Korean J Anesthesiol 2004; 47: 796∼802)
Alternative Title
Changes in Renal Function by Low Dose Dopamine in Patients Undergoing Hepatectomy with Low Central Venous Pressure Maintenance
Keimyung Author(s)(Kor)
장영호
김진모
김애라
강구정
Publisher
School of Medicine
Citation
유진균 et al. (2004). 간절제술 중 nitroglycerin을 이용한 저중심정맥압 유지기법 시 저용량 dopamine 투여에 의한 신기능 변화. 대한마취과학화지, 47(6), 796–802.
Type
Article
ISSN
2005-6419
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/38528
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Anesthesiology & Pain Medicine (마취통증의학)
1. School of Medicine (의과대학) > Dept. of Surgery (외과학)
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