[Suppression of the adrenal cortex by infusion of etomidate in general anesthesia].
The effects of anaesthesia with fentanyl and prolonged etomidate infusion (0.8 mg/kg/h) on the peroperative and postoperative change in blood concentrations of aldosterone, cortisol, dehydroepiandrosterone, ACTH, epinephrine, norepinephrine, dopamine, glucose, lactate and free fatty acids (FFA) were investigated in connection with major abdominal surgery. During surgery and anaesthesia with prolonged etomidate infusion no significant alterations in plasma catecholamine concentrations were observed. In contrast, basal plasma levels of ACTH (20.0 +/- 9.5 pg/ml----352.8 +/- 150.8 pg/ml) were elevated in all patients. Despite this endogenous ACTH stimulus, aldosterone (121.8 +/- 19.4 pg/ml----58.4 +/- 10.4 pg/ml) and cortisol (12.3 +/- 2.84 micrograms/dl----5.79 +/- 1.2 micrograms/dl) and dehydroepiandrosterone (2.28 +/- 1.09 ng/ml----1.27 +/- 0.25 ng/ml) levels were markedly depressed in every patient during the perioperative period. Twenty-four hours after surgery the basal steroid values were within or above normal limits.
D000005:Abdomen / Q000601:surgery; D000302:Adrenal Cortex / Q000187:drug effects*; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000450:Aldosterone / Q000097:blood; D000768:Anesthesia, General; D000769:Anesthesia, Inhalation; D000771:Anesthesia, Intravenous; D003687:Dehydroepiandrosterone / Q000097:blood; D004298:Dopamine / Q000097:blood; D004837:Epinephrine / Q000097:blood; D005045:Etomidate; D005283:Fentanyl; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007093:Imidazoles; D008875:Middle Aged; D009609:Nitrous Oxide; D009638:Norepinephrine / Q000097:blood
D007093:Imidazoles; D003687:Dehydroepiandrosterone; D000450:Aldosterone; D000324:Adrenocorticotropic Hormone; D009609:Nitrous Oxide; D005283:Fentanyl; D004298:Dopamine; D006854:Hydrocortisone; D009638:Norepinephrine; D004837:Epinephrine; D005045:Etomidate
Suppression der Nebennierenrinde durch Infusion von Etomidat während Allgemeinanästhesie.