Effect of additional general anesthesia with propofol, midazolam or sevoflurane on stress hormone levels in hysterectomy patients, receiving epidural anesthesia.
Hormonal responses after surgery are characterized by increased pituitary-adrenal axis hormones. We undertook this study to determine whether the choice of anesthesia influences stress hormone levels. Twenty-three adult females scheduled for hysterectomy for benign disease under general anesthesia were randomly assigned to one of three groups: epidural/propofol anesthesia (Group P), epidural/midazolam anesthesia (Group M), and epidural/sevoflurane anesthesia (Group S). The concentrations of ACTH and cortisol in group P and group M were significantly less than that of group S at 60 min after the incision. The concentrations of beta-endorphin and aldosterone in group P and group M were significantly less than that of group S at 60 min after the incision and after extubation. We conclude that combined epidural and general anesthesia with propofol or midazolam has a greater suppressive effect than sevoflurane on the stress response of the pituitary-adrenal axis during hysterectomy.
Department of Anesthesiology, Oita Medical University, Japan.
A
A
Mizutani
S
S
Hattori
S
S
Yoshitake
T
T
Kitano
T
T
Noguchi
D000305:Adrenal Cortex Hormones / Q000097:blood*; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D000368:Aged; D000450:Aldosterone / Q000097:blood; D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007044:Hysterectomy; D008738:Methyl Ethers / Q000008:administration & dosage*; D008874:Midazolam / Q000008:administration & dosage*; D008875:Middle Aged; D009609:Nitrous Oxide / Q000008:administration & dosage; D010907:Pituitary Hormones / Q000097:blood*; D010913:Pituitary-Adrenal System / Q000187:drug effects; D015742:Propofol / Q000008:administration & dosage*; D000077149:Sevoflurane; D013312:Stress, Physiological / Q000097:blood* / Q000503:physiopathology; D013997:Time Factors; D001615:beta-Endorphin / Q000097:blood
D000305:Adrenal Cortex Hormones; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D010907:Pituitary Hormones; D000077149:Sevoflurane; D000450:Aldosterone; D001615:beta-Endorphin; D000324:Adrenocorticotropic Hormone; D009609:Nitrous Oxide; D008874:Midazolam; D006854:Hydrocortisone; D015742:Propofol