Extracorporeal Circulation and Endogenous Epinephrine and Norepinephrine in Plasma, Atrium, and Urine in Man

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Abstract
In 25 patients epinephrine and norepinephrine concentrations were measured in urine preoperatively and postoperatively, in plasma and atrial tissue during thoracotomy before, during and after cardiopulmonary bypass. Ether or haiothane anesthesia was used. Both epinephrine and norepinephrine plasma levels rose during thoracotomy with either anesthetic. During bypass the levels continued to rise under ether but failed to change significantly under haiothane anesthesia. Induced hypothermia delayed the rise of plasma catecholamine levels during bypass. Atrial catecholamines did not change. Catecholamine levels were increased in the urine postoperatively with much higher excretion occurring in patients under ether anesthesia than under haiothane anesthesia. None of the patients required sympathomimetic drugs. The changes in catecholamine levels in plasma and urine are believed to reflect a normal response to anesthesia, surgical trauma, and extracorporeal circulation. Ether or haiothane anesthesia may modify this normal response significantly.