Endoluminal pelvic perfusion with norepinephrine causes only minor systemic effects and diminishes the increase in pelvic pressure caused by perfusion.

Endoluminal pelvic perfusion with norepinephrine causes only minor systemic effects and diminishes the increase in pelvic pressure caused by perfusion.

MedLine Citation:	PMID: 16303718 Owner: NLM Status: MEDLINE
Abstract/OtherAbstract:	OBJECTIVE: To evaluate the effect of endoluminal norepinephrine (NE) on transport pressures of the normal upper urinary tract of the pig and on plasma levels of NE in relation to possible systemic effects. MATERIAL AND METHODS: Six anaesthetized pigs weighing approximately 39 kg were studied. Transparenchymally, two 6-F catheters were introduced into the renal pelvis bilaterally to measure pressure and perfusion. Ultrasonic flow probes recorded renal arterial blood flow, and a transurethral 10-F catheter drained the bladder and monitored diuresis. In all six animals, the bilateral pelvic pressure response was examined at increasing perfusion rates (2, 4, 6, 8, 10 and 15 ml/min) and with increasing doses of NE (0, 5, 50 and 100 microg/ml). Arterial blood samples were analysed for NE, epinephrine and blood glucose. The systemic blood pressure, heart rate and electrocardiogram were registered. RESULTS: At all the investigated concentrations, endoluminal NE significantly diminished the increase in pelvic pressure caused by pelvic perfusion at all flow rates. At the lowest concentration of NE, no significant increase in the plasma level of NE was observed and the blood pressure did not increase. During perfusion with 50 and 100 microg/ml NE, plasma levels of NE increased significantly from 487+/-398 to 1798+/-910 and 2961+/-2093 pg/ml, respectively. This was accompanied by significant rises in mean systolic blood pressure from a baseline value of 95+/-10 mmHg to 111+/-20 and 118+/-23 mmHg, respectively. Heart rate, renal arterial blood flow and plasma levels of epinephrine and glucose did not change. CONCLUSIONS: Endoluminal NE diminished the increase in pelvic pressure caused by pelvic perfusion even at concentrations too low to cause significant changes in NE plasma levels or systemic effects. Very high NE concentrations in the perfusion fluid caused increased plasma levels and a modest but significant increase in blood pressure. Administration of endoluminal NE may be useful in upper urinary tract stone treatment and endoscopy.

Authors:	Uffe Holst; Yazan F Rawashdeh; Frederik Andreasen; Jens Christian Djurhuus; Jens Mortensen
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Publication Detail:	Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
Journal Detail:	Title: Scandinavian journal of urology and nephrology Volume: 39 ISSN: 0036-5599 ISO Abbreviation: Scand. J. Urol. Nephrol. Publication Date: 2005
Date Detail:	Created Date: 2005-11-23 Completed Date: 2006-03-02 Revised Date: 2006-11-15
Medline Journal Info:	Nlm Unique ID: 0114501 Medline TA: Scand J Urol Nephrol Country: Sweden
Other Details:	Languages: eng Pagination: 443-8 Citation Subset: IM
Affiliation:	Department of Surgery, Haderslev Sygehus, Haderslev, Denmark.
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MeSH Terms
Descriptor/Qualifier:	Adrenergic alpha-Agonists / administration & dosage, pharmacokinetics Animals Blood Pressure / drug effects, physiology Female Norepinephrine / administration & dosage, pharmacokinetics Pelvis / physiology Perfusion / methods Swine Urinary Bladder / drug effects, physiology* Urodynamics / drug effects*, physiology
Chemical
Reg. No./Substance:	0/Adrenergic alpha-Agonists; 51-41-2/Norepinephrine

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