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Canadian Journal of Anaesthesia

, Volume 48, Issue 4, pp 340–343 | Cite as

Endocrine response to surgical stress in three patients over 100 yr

  • Akira Kudoh
  • Hiroshi Katagai
  • Tomoko Takazawa
General Anesthesia

Abstract

Purpose: To report the change of plasma epinephrine, norepinephrine, cortisol, plasma renin activity, plasma aldosterone and plasma atrial natriuretic peptide during general anesthesia in three centenarian patients.

Clinical features: Three patients aged 101, 101 and 102-yr, underwent a screw fixation of femoral fracture under general anesthesia. Plasma concentrations of epinephrine, norepinephrine, cortisol, renin activity, aldosterone and atrial natriuretic peptide were measured before the induction of anesthesia, 15 min after incision and 60 min after the end of surgery. Plasma epinephrine concentrations in the three patients increased from 419, 344 and 377 pg·mg−1 before anesthesia to 688, 534 and 478 pg·ml−1 15 min after skin incision. Plasma norepinephrine concentrations increased markedly from 408, 513 and 606 pg·ml−1 before anesthesia to 2950, 1864 and 1574 pg·ml−1 15 min after skin incision. The cortisol response to surgery was similar to that of young adults. Plasma aldosterone and renin activity was low throughout anesthesia. Plasma atrial natriuretic peptide increased from 353, 367 and 109 pg·ml−1 before induction to 479, 487 and 168 pg·ml−1 15 min after skin incision.

Conclusion: Plasma norepinephrine concentration in patients over 10 0yr increased markedly during anesthesia, while plasma renin activity and aldosterone were lower.

Keywords

Aldosterone Atrial Natriuretic Peptide Plasma Renin Activity Femoral Neck Fracture Plasma Aldosterone 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Résumé

Objectif: Rendre compte des changements plasmatiques d’adrénaline, noradrénaline, cortisol, activité rénine, aldostérone et peptide natriurétique aurticulaire pendant l’anesthésie générale de trois patients centenaires.

Éléments cliniques: Trois patients de 101, 101 et 102 ans ont reçu une anesthésie générale pendant la fixation de vis pour une fracture fémorale. Les concentrations plasmatiques d’adrénaline, noradrénaline, cortisol, activité rénine, aldostérone et peptide natriurétique auriculaire ont été mesurées avant l’induction de l’anesthésie, 15 min après l’incision et 60 min après la fin de l’intervention. Les concentrations plasmatiques d’adrénaline ont augmenté chez les trois patients, passant de 419, 344 et 377 pg·ml−1 avant l’anesthésie à 688, 534 et 478 pg·ml−1 15 min après l’incision cutanée. Les concentrations plasmatique de noradrénaline se sont élevées de façon marquée, allant de 408, 513 et 606 pg·ml−1 avant l’anesthésie à 2950, 1864 et 1574 pg·ml−1 15 min après l’incision cutanée. La réponse du cortisol a été similaire à celle qu’on observe chez de jeunes adultes. L’aldostérone plasmatique et l’activité rénine sont demeurées faibles pendant toute l’anesthésie. Les peptides natriurétiques auriculaires sont passés de 353, 367 et 109 pg·ml−1 avant l’induction à 479, 487 et 168 pg·ml−1 15 min après l’incision cutanée.

Conclusion: La concentration plasmatique de noradrénaline a beaucoup augmenté pendant l’anesthésie de patients de plus de 100 ans, tandis que l’activité rénine et l’aldostérone sont demeurées faibles.

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Copyright information

© Canadian Anesthesiologists 2001

Authors and Affiliations

  • Akira Kudoh
    • 1
  • Hiroshi Katagai
    • 1
  • Tomoko Takazawa
    • 1
  1. 1.Department of AnesthesiologyHirosaki National HospitalAomoriJapan

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