Effects of prostaglandin E1 on renal function during deliberate hypotension with epidural anesthesia

We studied the effects of prostaglandin E1 (PGE1) on renal function during and after deliberate hypotension induced by epidural anesthesia. Twenty-seven ASA class 1 patients undergoing rotatory acetabular osteotomy were divided into three groups according to the dose of PGE1. Deliberate hypotension was induced and maintained during the surgery by epidural anesthesia combined with general anesthesia. PGE1 increased urine output and creatinine clearance (Ccr) during hypotension in dose dependent manner, and the changes were statistically significant compared with control at the dose of 0.02 micrograms.kg-1 x min-1 (gamma). PGE1 also tended to increase postoperative urine output and Ccr. Regardless of PGE1 administration, urine NAG/Cr ratio tended to increase during and after deliberate hypotension. Though total dose of local anesthetics was attenuated by PGE1, serum catecholamine levels of all patients were within normal ranges. In conclusion, PGE1 0.02 gamma is effective to maintain urine output during deliberate hypotension with epidural anesthesia. However, PGE1 is unlikely to prevent renal tubular damage at the dose less than 0.02 gamma.