Canadian Journal of Anesthesia, Vol 25, 312-318, Copyright © 1978 by Canadian Anesthesiologists' Society

Effects of General Anaesthesia and Surgery on Renal Function and Plasma ADH Levels

¹ Department of Anaesthesia, Hirosaki University, School of Medicine, Hirosaki, Aomori-ken, Japan, 036

Plasma levels of antidiuretic hormone (ADH) were evaluated in 40 adult patients during and after various types of anaesthesia and surgery. The plasma level of ADH increased significantly 30 minutes after the start of anaesthesia with diethyl-ether (3.7 times) and after thiopentone (1.5 times), but it increased insignificantly in neuroleptanaesthesia (2.4 times) and with halothane (1.3 times). The surgical stress evoked marked increases in plasma ADH levels especially at ten minutes after the skin incision. A slight increase in plasma ADH level still continued into the early post-operative days.

The effects of halothane anaesthesia on plasma levels of ADH and on both cortical and medullary renal blood flow (RBF) were investigated in dogs. RBF was measured by means of a heated thermocouple in two groups of eight dogs each. One group was given a high fluid load of 30 ml/kg/hr and the other a low load of 10 ml/kg/hr. The plasma level of ADH increased significantly with deepening halothane anaesthesia in the low fluid load group. However, in the high fluid load dogs it remained unchanged in spite of an increasing inspired halothane concentration. Both cortical and medullary RBF fell significantly as compared with the control values in the low fluid load group. However in the high fluid load dogs no significant was observed. These results would indicate that the anaesthetic agents investigated in the present study caused increases in plasma ADH levels, but that these antidiuretic effects of anaesthesia might be modified by the volume of fluid infused during anaesthesia and operation.