Etomidate anesthesia inhibits the cortisol response to surgical stress
- Resource Type
- Authors
- J. B. Dillman; Mohamed M. Ghoneim; J. H. Lemke; B. M. Sherman; M. P. Mehta
- Source
- Acta anaesthesiologica Scandinavica. 29(5)
- Subject
- Adult
endocrine system
medicine.medical_specialty
Surgical stress
Hydrocortisone
Adrenocorticotropic hormone
Postoperative Complications
Adrenocorticotropic Hormone
Etomidate
Pituitary Gland, Anterior
Stress, Physiological
Internal medicine
medicine
Adrenal insufficiency
Humans
Anesthetics
business.industry
Adrenal cortex
Imidazoles
General Medicine
medicine.disease
Prolactin
Anesthesiology and Pain Medicine
Endocrinology
medicine.anatomical_structure
Anesthesia
Methohexital
Growth Hormone
Adrenal Cortex
Cosyntropin
Female
business
Genital Diseases, Female
hormones, hormone substitutes, and hormone antagonists
medicine.drug
Adrenal Insufficiency
- Language
- ISSN
- 0001-5172
Plasma cortisol was measured in 18 patients undergoing gynecological procedures under etomidate or methohexital and nitrous oxide anesthesia. Plasma ACTH was also measured in three patients in each group. The mean plasma cortisol concentration before anesthesia was comparable in both groups. Plasma cortisol increased in patients anesthetized with methohexital, while none of the patients anesthetized with etomidate had an increase in plasma cortisol. The increase in plasma ACTH was equivalent in the two groups. Therefore, etomidate is a potent inhibitor of the adrenal response to surgery. The absence of clinical consequences associated with the blunted response suggests that a major increase in adrenal hormone production may not be necessary during surgery.