Renin and Vascular Homeostasis during Anesthesia

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Abstract
Plasma renin activity has been reported to be either normal or increased during anesthesia, probably depending on anesthetic dose and the agent used. The relative concentration of angiotensin II can be inferred from renin activity during anesthesia without concern about potential converting-enzyme blockade. Unfortunately there is no test for the importance of angiotensin II in any clinical situation, short of administering a specific inhibitor. The anesthetist cannot easily discern whether his patient is dependent on renin for maintenance of blood pressure or can depend on other homeostatic mechanisms as well. Whether these considerations bear on the choice of an anesthetic agent is not clear.