Effects of anesthesia and surgery on plasma endothelin levels.

To investigate the clinical significance of endothelin (ET), a potent and long-acting vasoconstrictor peptide in anesthesia and surgery, we measured plasma ET-like immunoreactivity (ET-LI) levels by using radioimmunoassay in patients undergoing various kinds of surgery under general anesthesia. No significant changes in plasma ET-LI levels were observed in patients undergoing relatively minor surgery under general anesthesia with nitrous oxide and halothane (n = 6), enflurane (n = 6), or isoflurane (n = 5). Although plasma ET-LI levels after surgery in patients undergoing total knee replacement (12.4 +/- 0.9 [mean +/- SEM] pg/mL, n = 7), hysterectomy (11.4 +/- 0.6 pg/mL, n = 8) or cholecystectomy (14.8 +/- 1.2 pg/mL, n = 9) were no different from those before surgery, plasma ET-LI levels after surgery in patients undergoing gastrectomy (20.4 +/- 1.9 pg/mL, n = 15), esophagectomy (24.7 +/- 2.5 pg/mL, n = 12), hepatectomy (27.5 +/- 3.4 pg/mL, n = 12), or heart surgery (43.1 +/- 4.1 pg/mL, n = 18) were higher than those before surgery (P < 0.05). Changes in plasma ET-LI levels during surgery had positive correlations with the duration of the operation (n = 100, r = 0.51, P < 0.01) and intraoperative blood loss (n = 100, r = 0.30, P < 0.01). In patients undergoing subtotal esophagectomy, the plasma ET-LI level did not increase during the initial 2 h, but increased gradually during surgery, reached a peak within a few hours after surgery, and declined slowly thereafter.(ABSTRACT TRUNCATED AT 250 WORDS)