title: The Hypothalamic-Pituitary-Adrenal Axis and Anesthetics: A Review.
abstract: The hypothalamic-pituitary-adrenal (HPA) axis is essential for human adaptation to stress. However, many anesthetic agents may interfere with the activity of this axis. Although etomidate is known for its suppressive effect on HPA axis function, in vitro evidence suggests that many other drugs used in anesthesia care may also interfere with HPA activity. In this review, we discuss the mechanisms by which all HPA axis activity may be altered during anesthesia and critical care and focus on the impact of hypnotic and analgesic drugs.
authors.affiliation: From the *Department of Anesthesiology and Critical Care, Rouen University Hospital, Rouen, France; †Inserm U1096 New Pharmacological Targets of Endothelial Dysfunction and Heart Failure; and ‡Inserm U982 Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Institute for Research and Innovation in Biomedicine, Normandie University, Rouen, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Besnier
authors.forename: Thomas
authors.initials: T
authors.lastname: Clavier
authors.forename: Vincent
authors.initials: V
authors.lastname: Compere
mesh_terms: D000777:Anesthetics / Q000008:administration & dosage*; D000818:Animals; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects* / Q000502:physiology*; D010913:Pituitary-Adrenal System / Q000187:drug effects* / Q000502:physiology*
chemical_list: D000777:Anesthetics; D006993:Hypnotics and Sedatives