Postoperative pancreatitis after total hip replacement under general anesthesia

A 61 year old male patient developed postoperative pancreatitis after total hip replacement under general anesthesia with sevoflurane. The patient had chronic renal failure and was receiving hemodialysis. The estimated intraoperative blood loss was 1500 ml, and 1200 ml of blood was administered. The intraoperative mean blood pressure was 60 to 70 mmHg and the central venous pressure at the end of anesthesia was 0 mmHg. Postoperatively he complained of severe upper abdominal pain. On the 1st postoperative day serum amylase level increased to fifteen times of the normal level. He complained again of severe abdominal pain on hemodialysis. From these episodes, we estimate that the circulatory disturbance of pancreas is the cause of this postoperative pancreatitis.