Hormonal responses to cardiac surgery: effects of sufentanil, somatostatin and ganglion block.
We have investigated the effect of the addition of somatostatin and trimetaphan to sufentanil 20 micrograms kg-1 on the hormonal responses to cardiac surgery and compared the changes with a control group receiving sufentanil and sodium nitroprusside. Eighteen patients undergoing elective valve replacement surgery were studied. Patients who received somatostatin and trimetaphan in addition to sufentanil had significantly smaller serum growth hormone and plasma glucagon concentrations compared with those who received sufentanil and sodium nitroprusside. The cortisol response to surgery was inhibited in both groups. There were no significant differences in catecholamine concentrations between the two groups. There was no effect of the additional inhibition of glucagon and growth hormone on circulating concentrations of glucose and lactate, but plasma concentrations of non-esterified fatty acids increased significantly. Thus the addition of somatostatin increased the suppression of the hormonal response to cardiac surgery by sufentanil.
Desborough
J P
JP
Department of Anaesthetics, Hammersmith Hospital, Royal Postgraduate Medical School, London.
Hall
G M
GM
Hart
G R
GR
Burrin
J M
JM
Bloom
S R
SR
D000368:Aged; D000768:Anesthesia, General; D000777:Anesthetics; D004837:Epinephrine / Q000097:blood; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D005283:Fentanyl / Q000031:analogs & derivatives*; D005934:Glucagon / Q000097:blood; D013006:Growth Hormone / Q000097:blood; D006350:Heart Valve Prosthesis; D006400:Hematocrit; D006728:Hormones / Q000097:blood*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007328:Insulin / Q000097:blood; D007773:Lactates / Q000097:blood; D008297:Male; D008875:Middle Aged; D009599:Nitroprusside / Q000494:pharmacology; D009638:Norepinephrine / Q000097:blood; D013004:Somatostatin / Q000494:pharmacology*; D017409:Sufentanil; D014294:Trimethaphan / Q000494:pharmacology*
D000777:Anesthetics; D005230:Fatty Acids, Nonesterified; D006728:Hormones; D007328:Insulin; D007773:Lactates; D009599:Nitroprusside; D013004:Somatostatin; D014294:Trimethaphan; D013006:Growth Hormone; D005934:Glucagon; D017409:Sufentanil; D005283:Fentanyl; D006854:Hydrocortisone; D009638:Norepinephrine; D004837:Epinephrine