개심술시 사용한 고용량 Morphine 마취가 혈장 Atrial Natriuretic Peptide 농도 Renin 활성도 및 신장기능에 미치는 영향 = Effect of High Dose Morphine Anesthesia on the Plasma ANP Level, Renin Activity and Renal Function in Patient with Cardiac Surgery

다국어 초록 (Multilingual Abstract)

Recent research has led to the discovery and characterization of a hormone secreted by the atria that has powerful vasopressive and natriuretic properties. Various atrial natriuretic peptides(ANP) were isolated and synthetized, and the effects were investigated by many workers.
This study was attempted to access the effects of high dose morphine anesthesia on the plasma ANP level, renin activity and renal function in patients with cardiac surgery.
Anesthesia was induced with morphine and maintained with 50% nitrous oxide in oxygen. Supple-mentary dose of morphine was given during the anesthesia according to responses of patients.
The results were as follows:
1) The blood pressure and heart rate were not chaged significantly during anesthesia compared with the control values.
2) There was no statistically signigicant difference of plasma ANP level compared with the control values.
3) The plasma concentration of renin was markedly elevated after 30 minutes of induction time and sustained it during the anesthesia. Recovery to normal range of plasma renin concentration was observed after 2 days of surgery. This change is much the same as the other anesthetic methods.
4) Tendency of decreasing urine volume was shown just after the induction period but restored to control level immediately.
5) The renal excretory rate of sodium chloride and fractional excretion of sodium was significantly decreased during anesthesia and restored to control level after surgery.
These results show that morphine anesthesia dose not produce significant alteration of both ANP and renin-angiotensin system.