Effect of dopamine on parathyroid hormone release during surgery.

There is much evidence that dopamine (DA) may play an important role in modulating parathyroid gland function. DA stimulates parathyroid hormone (PTH) secretion in cattle, which increases ionized calcium, but is without such effect on humans under normal physiological conditions. Ionized calcium plays a major role in muscle contraction including myocardial contractility. Therefore, we studied the PTH response to infusion of DA (4 micrograms/kg/min) under pathophysiological states during two different types of surgery; gastrectomy with halothane anesthetics and open heart surgery with high-dose fentanyl anesthetics. There was no change in PTH concentration, as measured by radioimmunoassay, in patients undergoing gastrectomy, although infusion of DA in these patients was effective in lowering the prolactin levels. However, plasma PTH concentration significantly increased where DA was applied (4 micrograms/kg/min) in patients undergoing open heart surgery. These results suggest that DA may stimulate PTH secretion by an indirect mechanism in humans under pathophysiological states, although details of the mechanism are unknown, and that there is the possibility that DA would indirectly regulate the levels of electrolytes such as ionized calcium and phosphate in patients undergoing open heart surgery mediated by elevation of PTH.