Isoflurane decreases the cortisol response to cardiopulmonary bypass.
Eighteen patients with normal left ventricular function scheduled for elective myocardial revascularization were anesthetized with fentanyl (52-58 micrograms/kg). At the beginning of hypothermic cardiopulmonary bypass (CPB) they were assigned to a control (C) group (n = 6) that did not receive further anesthesia, or to a group given either 1% isoflurane (n = 6) or 2% isoflurane (n = 6). Blood samples for measurement of total plasma cortisol concentrations were obtained before, during, and after CPB. Hemodynamic measurements before and after CPB were not different among groups. Patients in group C required higher infusion rates of sodium nitroprusside (P less than or equal to 0.05) and patients given 2% isoflurane received more phenylephrine (P less than or equal to 0.05) to keep mean arterial pressure at 50 +/- 10 mm Hg during CPB. Isoflurane caused a dose-related decrease in total plasma cortisol concentrations during and after CPB. We conclude that increased depth of anesthesia attenuates the cortisol (stress) response to cardiopulmonary bypass.
D002315:Cardiopulmonary Bypass; D003864:Depression, Chemical; D005283:Fentanyl / Q000494:pharmacology; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007530:Isoflurane / Q000494:pharmacology*; D008875:Middle Aged; D013312:Stress, Physiological / Q000097:blood
D007530:Isoflurane; D005283:Fentanyl; D006854:Hydrocortisone