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Effects of halothane anaesthesia and surgery on adrenocortical function in man

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Summary and Conclusions

The present study was undertaken to investigate whether or not preanaesthetic medication and halothane anaesthesia affect adrenal cortical function in man as judged by their influence on the plasma levels of free 17-hydroxycorticosteroids. The blood samples were taken in the morning between 8:15 and 8.45 A.M. before induction of anaesthesia, during anaesthesia alone, during surgery, and in the recovery room. The determination of free 17-OHCS in plasma was made by Peterson’s modification of the Porter-Silber method. Twenty patients were given halothane anaesthesia and another eleven patients received premedication alone without anaesthesia.

The mean plasma level of 17-OHCS in the preanaesthetic period was in the range of 10.0-10.8 µg. per 100 ml., which was significantly lower than for the non-premedicated patients. Although halothane anaesthesia for 15 minutes after induction with thiopental evoked slight but insignificant increase of 17-OHCS level, halothane anaesthesia for 30 minutes without employing thiopental significantly increased the plasma 17-OHCS levels above the preinduction levels, from 10.8 ± 1.4 to 17.5 ± 1.6 μg. (± = standard error) per 100 ml. The surgical stress increased plasma 17-OHCS levels markedly. These findings indicate that halothane anaesthesia has a stimulating effect on adrenal cortical function in man.

Résumé

Le présent travail a été entrepris pour chercher si oui ou non la prémédication et l’anesthésie à l’halothane affectent la fonction du cortex surrénalien chez l’homme, autant qu’on peut en juger par leur influence sur les niveaux plasma-tiques des 17-hydroxycorticostéroides en liberté. Les échantillons de sang ont été prélevés le matin entre 8:15 et 8:45 heures, avant l’induction de l’anesthésie, durant l’anesthésie seule, durant l’opération et dans la salle de réveil. Le dosage des 17-OHCS libres dans le plasma a été fait par la méthode de Porter-Silber, modifiée par Peterson. Vingt malades ont reçu une anesthésie à Thalothane et onze autres malades n’ont reçu que la prémédication sans anesthésie. Le niveau plasmatique moyen des 17-OHCS dans la période pré-anesthésique se tenait entre 10.0 et 10.8 mg. par 100 c.c, ce qui était sensiblement inférieur à ce qu’on trouve chez les non-prémédiqués. Bien que l’anesthésie à l’halothane durant 15 minutes après l’induction au pentothal n’ait produit qu’une augmentation sans importance du niveau des 17-OHCS, l’anesthésie à l’halothane durant 30 minutes (sans utiliser de pentothal) a sensiblement augmenté les niveaux plasmatiques des 17-OHCS au dessus des niveaux antérieurs à l’induction, de 10.8 ± 1.4 à 17.5 ± 1.6 mg. par 100 c.c. Le stress chirurgical a augmenté de façon marquée les niveaux plasmatiques des 17-OHCS. Ces résultats indiquent que l’anesthésie à l’halothane a un effet stimulant sur la fonction du cortex surrénalien chez l’homme.

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Correspondence to Tsutomu Oyama or S. Shibata or F. Matusmoto or M. Takiguchi or T. Kudo.

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Oyama, T., Shibata, S., Matusmoto, F. et al. Effects of halothane anaesthesia and surgery on adrenocortical function in man. Can. Anaesth. Soc. J. 15, 258–266 (1968). https://doi.org/10.1007/BF03008738

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Keywords

  • Halothane
  • Halothane Anaesthesia
  • Adrenocortical Function
  • Succinylcholine Chloride
  • Plasma Free Cortisol