Stress hormone responses to major intra-abdominal surgery during and immediately after sevoflurane-nitrous oxide anaesthesia in elderly patients.
We studied the responses of plasma epinephrine, norepinephrine, adrenocorticotropic hormone (ACTH), cortisol, and antidiuretic hormone (ADH) during and immediately after sevoflurane-nitrous oxide anaesthesia supplemented with vecuronium in seven elderly patients (mean 76.6 +/- 1.7 SEM) who underwent major intra-abdominal surgery. The plasma concentrations of norepinephrine, ACTH, cortisol, and ADH increased in response to surgical procedures (P < 0.05). The plasma concentration of ADH increased to a peak concentration of 189.1 +/- 20.7 pg.ml-1 30 min after skin incision (P < 0.05). The plasma concentrations of epinephrine, norepinephrine, ACTH, and cortisol increased to peak concentrations of 408.6 +/- 135.5 pg.ml-1, 635.7 +/- 167.8 pg.ml-1, 222.6 +/- 48.0 pg.ml-1, and 113.6 +/- 67.5 micrograms.dl-1, respectively immediately after tracheal extubation (P < 0.05). We conclude that, in the elderly patients, the responses of stress hormones to major intra-abdominal surgery were preserved during sevoflurane-nitrous oxide anaesthesia sufficient to prevent increases in arterial pressure and heart rate. The strongest responses of epinephrine, norepinephrine, ACTH, and cortisol were elicited immediately after tracheal extubation.
Furuya
K
K
Department of Anesthesiology, Jichi Medical School, Tochigi, Japan.
Shimizu
R
R
Hirabayashi
Y
Y
Ishii
R
R
Fukuda
H
H
D000005:Abdomen / Q000601:surgery*; D000324:Adrenocorticotropic Hormone / Q000097:blood*; D000368:Aged; D000369:Aged, 80 and over; D000769:Anesthesia, Inhalation; D000777:Anesthetics / Q000008:administration & dosage; D001794:Blood Pressure; D062109:Dermatologic Surgical Procedures; D004837:Epinephrine / Q000097:blood*; D004987:Ethers / Q000008:administration & dosage; D005260:Female; D006339:Heart Rate; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007442:Intubation, Intratracheal; D008297:Male; D008738:Methyl Ethers; D009609:Nitrous Oxide / Q000008:administration & dosage; D009638:Norepinephrine / Q000097:blood*; D000077149:Sevoflurane; D014667:Vasopressins / Q000097:blood*
D000777:Anesthetics; D004987:Ethers; D008738:Methyl Ethers; D014667:Vasopressins; D000077149:Sevoflurane; D000324:Adrenocorticotropic Hormone; D009609:Nitrous Oxide; D006854:Hydrocortisone; D009638:Norepinephrine; D004837:Epinephrine