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.
Department of Anesthesiology, Jichi Medical School, Tochigi, Japan.
K
K
Furuya
R
R
Shimizu
Y
Y
Hirabayashi
R
R
Ishii
H
H
Fukuda
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