[Changes in plasma cortisol and ACTH caused by diazepam, bromazepam, triazolam, and alprazolam in oral premedication].
BACKGROUND
Benzodiazepines relieve anxiety and modify the endocrine response to surgical-anesthetic stress.


OBJECTIVE
The aim of this study was to evaluate the effects of four benzodiazepines on preoperative secretion of cortisol and ACTH.


METHODS
We studied 60 patients programmed for abdominal surgery. Patients were randomly allocated into six groups of treatment: control group (placebo), diazepam 10 mg, triazolam 0.5 mg, alprazolam 0.5 mg, bromazepam 6 mg, and bromazepam 12 mg. Blood samples for cortisol and ACTH measurements were obtained at five different stages of the anesthetic-surgical procedure: baseline, preanesthesia, anesthesia, surgery, and postoperative phase.


RESULTS
Diazepam and bromazepam (6 and 12 mg) lessened the increase in plasmatic cortisol induced by preanesthesia and anesthesia in control patients. Triazolam attenuated the cortisol response only during preanesthesia. Administration of 12 mg of bromazepam decreased ACTH levels during preanesthesia and anesthesia with respect to the control group.


CONCLUSIONS
Benzodiazepines failed to modify cortisol and ACTH levels during surgery and during the immediate postoperative period. The most marked attenuation of adrenocortical response was achieved with 12 mg of bromazepam and the less marked lessening was induced by 0.5 mg of alprazolam.
Rodríguez-Huertas
F
F
Servicio de Anestesiología, Hospital del SAS. Jerez, Facultad de Medicina, Cádiz.
Carrasco
M S
MS
García-Baquero
A
A
Coq
F D
FD
Freire
J
J
D000324:Adrenocorticotropic Hormone / Q000097:blood*; D000328:Adult; D000368:Aged; D000525:Alprazolam / Q000008:administration & dosage / Q000494:pharmacology*; D001960:Bromazepam / Q000008:administration & dosage / Q000494:pharmacology*; D003975:Diazepam / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011229:Preanesthetic Medication; D013315:Stress, Psychological / Q000097:blood / Q000188:drug therapy; D014229:Triazolam / Q000008:administration & dosage / Q000494:pharmacology*
D014229:Triazolam; D000324:Adrenocorticotropic Hormone; D003975:Diazepam; D006854:Hydrocortisone; D001960:Bromazepam; D000525:Alprazolam
Modificaciones de las concentraciones plasmáticas de cortisol y ACTH producidas por diazepam, bromazepam, triazolam y alprazolam en premedicación oral.