1987 Volume 7 Issue 1 Pages 106-113
We investigated endocrinic responses of controlled hypotension by induced adenosine triphos-phate (ATP) with and without pretreatment of dipyridamole (intracellular uptake inhibitor of ATP) in 29 female patients recieved hip arthroplasty.
8 patients(group 1) were recieved controlled hypotension by ATP alone and 12 patients(group 2) by ATP with the pretreatment of dipyridamole (0.2mg/kg). The remaining 9 patients (group 3), who did not recieved controlled hypotension, served as control. All patients recieved neuroleptanesthesia, consisting of droperidol, fentanyl, pancuronium, and nitrous oxide. Systolic arterial blood pressure was maintained at 80mmHg for 60 minutes in hypoten-sive group.
We measured plasma concentration of cathecholamine, cortisol, uric acid, inorganic phosphate(breakdown products of ATP), and plasma renin activity(PRA).
Main results are as follow. (1) pretreatment of dipyridamole reduced requirement of ATP from 0.32mg/kg/min. (group 1) to 0.09mg/kg/min. (group 2). (1) According to the dose of ATP, plasma concentration of adrenaline and PRA were decreased, whereas plasma concentration of cortisol was increased. (3) As for plasma concentration of uric acid in group 1 and 2 increased significantly compared with in group 3. but plasma concentration of uric acid in group 2 was less than that in group 1.
From these results, controlled hypotension by ATP with the pretreatment of dipyridamole can be used safely, so as to attenuate the dose of ATP and consequently reduced the breakdown products of ATP.
