Effects Of Combined General-epidural Anesthesia On Plasma Renin,Angiotensin â…¡ And Renal Functions Following Retroperitoneoscopic Surgery

Objective To investigate the changes of plasma renin,AngiotensinⅡand the renal functions following retroperitoneoscopic surgery so as to provide the best anesthetical method for helping patients undergoing retroperitoneoscopic surgery pass perioperative period safely.Methods Fourty patients(ASAⅠ-Ⅱ)undergoing retroperitoneoscopic surgery for renal cyst was included in the study.They were randomly divided into anesthetical group (group G) and combined general—epidural anesthetical group(group GE).All patients received the same anesthetical performs and drugs.Group GE received the epidural anesthesia in addition.Plasma renin(PRA),angiotensinⅡ(AⅡ),cystatin C(Cys C) andα1-MG in urine were determinated at preanesthesia(T0),30 min during pneumoperitoneum(T1),10 min after pneumoperitoneum(T2),1d after the operation (T3) with RIA.Analyse all the parameters deprived from the different time.Results①In group G,the concentration of plasma PRA at T1 and T2 were all higher than that at T0(P＜0.05);Furthermore,this concentration at T1 in group GE was significantly lower than that in group G(P＜0.01).②In group G,the concentration of plasma AⅡat T1 and T2 were all higher than that at T0(P＜0.05).③In group G,the concentration of blood CysC at T1 and T2 were all higher than that at T0 (P＜0.01);Furthermore,this concentration at T2 in group GE was significanfly lower than that in group G(P＜0.05).④In group G,the concentration ofα1-MG in urine at T1,T2 and T3 were all higher than that at T0(P＜0.05);Furthermore,these concentrations at T1,T2 and T3 in group GE were significantly lower than that in group G(P＜0.05).Conclusion The retroperitoneoscopic surgery can increase the neuroendocrine responses,may be harmful to the renal functions;the combined general—epidural anesthesia can inhibit the neuroendocrine responses during retroperitoneoscopic surgery and restore the renal functions.