title: [Interaction between hypnotic agents and the hypothalamic-pituitary-adrenocorticotropic axis during surgery].
abstract: During stress, the relationship between the central nervous system and the immune system is essential to maintain homeostasis. The main neuroendocrine system involved in this interaction is the hypothalamic-pituitary-adrenal axis (HPA), which via the synthesis of glucocorticoids will modulate the intensity of the inflammatory response. Anaesthetic agents could be interacting with the HPA axis during surgery. Although etomidate currently remains in the center of the discussions, it seems, at least experimentally, that most hypnotics have the capacity to modulate the synthesis of adrenal steroids. Nevertheless, with the large literature on this subject, etomidate seems to be the most deleterious hypnotic agent on the HPA axis function. Its use should be limited when HPA axis is already altered.
authors.affiliation: Département d'anesthésie-réanimation chirurgicale - SAMU, CHU de Rouen, 1, rue de Germont, 76031 Rouen, France; Inserm U982, DC2N Laboratory of Neuronal and Neuroendocrine Cell Differentiation and Communication, Astrocyte and Vascular Niche, IRIB, University of Rouen, PRES Normandy, 76821 Mont-Saint-Aignan, France.
authors.forename: E
authors.initials: E
authors.lastname: Besnier
authors.affiliation: Département d'anesthésie-réanimation chirurgicale - SAMU, CHU de Rouen, 1, rue de Germont, 76031 Rouen, France; Inserm U982, DC2N Laboratory of Neuronal and Neuroendocrine Cell Differentiation and Communication, Astrocyte and Vascular Niche, IRIB, University of Rouen, PRES Normandy, 76821 Mont-Saint-Aignan, France.
authors.forename: T
authors.initials: T
authors.lastname: Clavier
authors.affiliation: Inserm U982, DC2N Laboratory of Neuronal and Neuroendocrine Cell Differentiation and Communication, Astrocyte and Vascular Niche, IRIB, University of Rouen, PRES Normandy, 76821 Mont-Saint-Aignan, France.
authors.forename: H
authors.initials: H
authors.lastname: Castel
authors.affiliation: Inserm U982, DC2N Laboratory of Neuronal and Neuroendocrine Cell Differentiation and Communication, Astrocyte and Vascular Niche, IRIB, University of Rouen, PRES Normandy, 76821 Mont-Saint-Aignan, France.
authors.forename: P
authors.initials: P
authors.lastname: Gandolfo
authors.affiliation: Inserm U982, DC2N Laboratory of Neuronal and Neuroendocrine Cell Differentiation and Communication, Astrocyte and Vascular Niche, IRIB, University of Rouen, PRES Normandy, 76821 Mont-Saint-Aignan, France.
authors.forename: F
authors.initials: F
authors.lastname: Morin
authors.affiliation: Inserm U982, DC2N Laboratory of Neuronal and Neuroendocrine Cell Differentiation and Communication, Astrocyte and Vascular Niche, IRIB, University of Rouen, PRES Normandy, 76821 Mont-Saint-Aignan, France.
authors.forename: M-C
authors.initials: MC
authors.lastname: Tonon
authors.affiliation: Département d'anesthésie-réanimation chirurgicale - SAMU, CHU de Rouen, 1, rue de Germont, 76031 Rouen, France.
authors.forename: C
authors.initials: C
authors.lastname: Marguerite
authors.affiliation: Département d'anesthésie-réanimation chirurgicale - SAMU, CHU de Rouen, 1, rue de Germont, 76031 Rouen, France.
authors.forename: B
authors.initials: B
authors.lastname: Veber
authors.affiliation: Département d'anesthésie-réanimation chirurgicale - SAMU, CHU de Rouen, 1, rue de Germont, 76031 Rouen, France.
authors.forename: B
authors.initials: B
authors.lastname: Dureuil
authors.affiliation: Département d'anesthésie-réanimation chirurgicale - SAMU, CHU de Rouen, 1, rue de Germont, 76031 Rouen, France; Inserm U982, DC2N Laboratory of Neuronal and Neuroendocrine Cell Differentiation and Communication, Astrocyte and Vascular Niche, IRIB, University of Rouen, PRES Normandy, 76821 Mont-Saint-Aignan, France. Electronic address: Vincent.Compere@chu-rouen.fr.
authors.forename: V
authors.initials: V
authors.lastname: Compère
mesh_terms: D000305:Adrenal Cortex Hormones / Q000096:biosynthesis; D004347:Drug Interactions; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects*; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects*; D007431:Intraoperative Complications / Q000139:chemically induced*; D010913:Pituitary-Adrenal System / Q000187:drug effects*; D013514:Surgical Procedures, Operative / Q000009:adverse effects
chemical_list: D000305:Adrenal Cortex Hormones; D006993:Hypnotics and Sedatives
keywords: Agents hypnotiques; Anaesthetic agent; Axe hypothalamo-hypophyso-surrénalien; Hypothalamic-pituitary-adrenal axis; Steroids; Stéroïdes