Isoflurane pp 257-266 | Cite as

Plasma Levels of Stress Hormones Under Isoflurane Anaesthesia in Comparison to Other Anaesthetic Techniques

  • S. Fitzal
  • C. Spiss
  • S. Schwarz
  • M. Weindlmayr-Göttel
  • M. Winkler
Conference paper
Part of the Anaesthesiology Intensive Care Medicine/Anaesthesiologie und Intensivmedizin book series (A+I, volume 182)

Abstract

An anaesthestic agent can be evaluated not only with regard to its influence on homeostasis as such but also in terms of its ability to protect the organism from surgical stress. Responses to surgical trauma are largely mediated through the autonomic nervous system and adrenal medulla and are, therefore, reflected by increases in heart rate, blood pressure, and concentrations of stress-associated substances in the circulation during and after surgery. Increases in Cortisol and catecholamines are considered to be reliable indicators of surgical trauma and manifestations of the physiological response to stress [21, 25]. It has also been suggested that beta-endorphins play a definite role in the biologic response to stress as well as in the endogenous mode of pain perception [12].

Keywords

Cortisol Catecholamine Diazepam Fentanyl Midazolam 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Bedford RF, Marshall WK (1984) Cardiovascular response to endotracheal intubation during four anesthetic techniques. Acta Anaesth Scand 28: 563–566PubMedCrossRefGoogle Scholar
  2. 2.
    Brismar B, Hedenstierna G, Lundh R, Tokics L (1982) Oxygen uptake, plasma catecholamines and cardiac output during neurolept-nitrous oxide and halothane anaesthesia. Acta Anaesth Scand 26: 541–549PubMedCrossRefGoogle Scholar
  3. 3.
    Brown FF III, Owens WD, Felts JA, Spitznagel EL, Cryer PE (1982) Plasma epinephrine and norepinephrine levels during anesthesia: enflurane-N2O-O2 compared with fentanyl N2O-O2. Anesth Analg 61: 366–370PubMedGoogle Scholar
  4. 4.
    Cork RC, Hameroff SR, Weiss JL (1985) Effects of halothane and fentanyl anesthesia on plasma ß-endorphin immunoreactivity during cardiac surgery. Anesth Analg 64: 677–680PubMedCrossRefGoogle Scholar
  5. 5.
    Cummings MF, Russell WJ, Frewin DB (1983) Effects of pancuronium and alcuronium on the changes in arterial pressure and plasma catecholamine concentrations during tracheal intubation. Br J Anaesth 55: 619–623PubMedCrossRefGoogle Scholar
  6. 6.
    Derbyshire DR, Smith G (1984) Sympathoadrenal responses to anaesthesia and surgery. Br J Anaesth 56: 725–739PubMedCrossRefGoogle Scholar
  7. 7.
    Derbyshire DR, Chmielewski A, Vater M, Achola K, Smith G (1983) Plasma catecholamine responses to tracheal intubation. Br J Anaesth 55: 855–860PubMedCrossRefGoogle Scholar
  8. 8.
    Derbyshire DR, Hunt PCW, Achola K, Smith G (1984) Midazolam and thiopentone: catecholamine and arterial pressure responses to induction and endotracheal intubation. Br J Anaesth 56: 429 PCrossRefGoogle Scholar
  9. 9.
    Dubois M, Pickar D, Cohen M, Gadde P, Macnamara TE, Bunney WE (1982) Effects of fentanyl on the response of plasma beta-endorphin immunoreactivity to surgery. Anesthesiology 57: 468–472PubMedCrossRefGoogle Scholar
  10. 10.
    Fell D, Derbyshire DR, Maile CJD, Larsson IM, Ellis R, Achola KJ, Smith G (1985) Measurement of plasma catecholamine concentrations. An assessment of anxiety. Br J Anaesth 57: 770–774PubMedCrossRefGoogle Scholar
  11. 11.
    Glisson SN, Balasaraswathi K (1981) Isoflurane sympathoadrenal responses in man compared to enflurane and halothane. Anesthesiology 55 (Suppl.): A296Google Scholar
  12. 12.
    Guillemin R, Vargo T, Rossier J, Minick S, Ling N, Rivier C, Vale W, Bloom F (1977) ß-endorphin and adrenocorticotropin are secreted concomitantly by the pituitary gland. Science 197: 1367–1369PubMedCrossRefGoogle Scholar
  13. 13.
    Hamberger B, Järnberg PO (1983) Plasma catecholamines during surgical stress: differences between neurolept and enflurane anaesthesia. Acta Anaesth Scand 27: 307–310PubMedCrossRefGoogle Scholar
  14. 14.
    Hjemdahl P, Daleskog M, Kohan T (1979) Determination of plasma catecholamines by high performance liquid chromatography with electrochemical detection: a comparison with a radioenzymatic method. Life Sci 25: 131–138PubMedCrossRefGoogle Scholar
  15. 15.
    Höllt V, Müller OA, Fahlbusch R (1979) ß-endorphin in human plasma: basal and pathologically elevated levels. Life Sci 25: 37–44PubMedCrossRefGoogle Scholar
  16. 16.
    Järnberg PO, Efendic S, Hamberger B (1982) Hormonal and metabolic changes during neurolept and isoflurane anaesthesia. Anesthesiology 57: A247CrossRefGoogle Scholar
  17. 17.
    Johnson GA, Peuler J, Baker CA (1977) Plasma catecholamine concentrations in normal subjects. Curr Ther Res 21: 898–902Google Scholar
  18. 18.
    Joyce JT, Roizen MF, Gerson JI, Grobecker H, Eger EI II, Forbes AR (1982) Induction of anesthesia with halothane increases plasma norepinephrine concentrations. Anesthesiology 56: 286–290PubMedCrossRefGoogle Scholar
  19. 19.
    Joyce JT, Roizen MF, Eger EI II (1983) Effect of thiopental induction on sympathetic activity. Anesthesiology 59: 19–22PubMedCrossRefGoogle Scholar
  20. 20.
    Nigrovic C, Mc Cullough LS, Wajskol A, Levin JA, Martin JT (1983) Succinylcholine-induced increases in plasma catecholamine levels in humans. Anesth Analg 62: 627–632PubMedCrossRefGoogle Scholar
  21. 21.
    Oyama T (1973) Endocrine responses to anesthestic agents. Br J Anaesth 45: 276–281PubMedCrossRefGoogle Scholar
  22. 22.
    Parikh RK, Naismith Sewnauth D, Campbell BC, Reid JL (1982) Comparison of halothane and fentanyl supplementation to general anaesthesia on the stress response of patients undergoing upper abdominal surgery. Br J Anaesth 54: 23 I PCrossRefGoogle Scholar
  23. 23.
    Rawlinson WAL, Loach AB, Benedict CR (1978) Changes in plasma concentration of adrenaline and noradrenaline in anaesthetized patients during sodium nitroprusside-induced hypotension. Br J Anaesth 50: 937–943PubMedCrossRefGoogle Scholar
  24. 24.
    Reitan JA, Stengert KB, Wymore ML, Martucci RW (1978) Central vagal control of fentanyl induced bradycardia during halothane anaesthesia. Anesth Analg 57: 31–36PubMedGoogle Scholar
  25. 25.
    Selye H (1976) Stress in health and disease. Butterworths, LondonGoogle Scholar
  26. 26.
    Skovsted P, Price ML, Price HL (1970) the effects of shortacting barbiturates on arterial pressure, preganglionic sympathetic activity and barostatic reflexes. Anesthesiology 33: 10–18PubMedCrossRefGoogle Scholar
  27. 27.
    Stoelting RK (1977) Circulatory changes during direct laryngoscopy and tracheal intubation: influence of duration of laryngoscopy with or without prior lidocaine. Anesthesiology 47: 381–384PubMedCrossRefGoogle Scholar
  28. 28.
    Traynor C, Hall GM (1981) Endocrine and metabolic changes during surgery: anaesthetic implications. Br J Anaesth 53: 153–16029.PubMedCrossRefGoogle Scholar
  29. 29.
    Weatherhill D, Spence AA (1984) Anaesthesia and disorders of the adrenal cortex. Br J Anaesth 56: 741–749CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1986

Authors and Affiliations

  • S. Fitzal
  • C. Spiss
  • S. Schwarz
  • M. Weindlmayr-Göttel
  • M. Winkler

There are no affiliations available

Personalised recommendations