Effects of halothane anaesthesia and surgery on adrenocortical function in man

Effect of non-adrenal illness, anaesthesia and surgery on plasma cortisol concentrations in dogs

Basal plasma cortisol concentrations in 25 dogs with non-adrenal illness were two to three times higher than in 25 normal dogs (158 +/- 25 nmol litre-1 compared with 65 +/- 22; mean +/- SD). In addition, plasma cortisol concentrations were measured in 12 animals undergoing major abdominal, thoracic or orthopaedic surgery and compared to a group of six anaesthetised dogs. Anaesthesia alone failed to significantly alter plasma cortisol levels, however, all forms of surgery produced a significant increase in plasma cortisol concentration which returned to normal 24 hours after completion of surgery.

Effects of surgery and general or epidural anesthesia on plasma levels of cortisol, growth hormone and prolactin in infants under one year of age

Twenty infants under one yr of age undergoing minor surgery were divided in two groups according to the type of anesthesia (epidural, Group 1, n = 10; general, Group 2, n = 10) which was randomly performed. Blood samples for cortisol (F), growth hormone (GH), and prolactin (PRL) determination were taken from each infant in baseline conditions, before surgery, and at the end of surgery. Mean plasma F levels in infants of group 2 rose significantly (p less than 0.01) before surgery to attend a maximum at the end of surgery (p less than 0.005). In infants of Group 1 a significant increase was also observed before surgery (p less than 0.05) but at the end of surgery mean plasma cortisol returned to levels comparable to baseline. Mean GH plasma levels were not significantly affected by both types of anesthesia, however an increase (not statistically significant) was observed at the end of surgery in both groups. Mean plasma PRL levels showed a significant increase before surgery (p less than 0.05 and p less than 0.01 in group 1 and 2, respectively) and a further increase at the end of surgery in both groups of infants (p less than 0.005). These results suggest that in infants under one yr of age both types of anesthetic procedures preceding surgery have no significant effect on plasma GH, but produce a significant increase of cortisol and prolactin mean plasma levels. The cortisol response to surgery and general or epidural anesthesia was similar to that reported in adults and prepubertal boys.(ABSTRACT TRUNCATED AT 250 WORDS)

Survival rates of breast carcinoma patients after surgery and anaesthetic

Eighty-nine breast cancer patients were studied for the end result of therapy. During surgery, the anaesthesia administered was either halothane (61 cases) or ether (28 cases) mixture with nitrogen and oxygen. The holstead method for mastectomy was used for all cases. The results showed that the type of anaesthesia influenced the end results of therapy of breast cancer patients. The survival rates of patients receiving halothane were much higher than those of ether anaesthetized cases. The differences were most pronounced among cases who received both preoperative radiotherapy and postoperative chemotherapy, and in cases with metastasis into regional lymph node. A comparison of groups of patients on the basis of such parameters as the anaesthetic used, age and degree of tumor progression (according to TNM classification and post-operative histological assays) showed them to well matched. These results may be explained by the effects of the anaesthesia on the role of immunity in controlling tumor cell implantation and growth of metastasis.

The influence of the anaesthetic on survival rates of breast cancer patients after surgery

The end results of therapy of 1,358 breast cancer patients were studied. Anaesthesia was performed by ether-nitrogen-oxygen (554 cases) or halothane-nitrogen-oxygen (804 cases) mixture with addition of oxygen. The method of Holstead was employed in all cases. A comparison of groups of patients on the basis of such parameters as the anaesthetic used, age and degree of tumour progression (according to the TNM classification and results of post-operative histological assays) showed them to be identical. The study showed that the type of anaesthesia influenced the end results of therapy of cancer patients: the survival rates of patients receiving halothane anaesthesia were much higher than those of the ether-anaesthetized patients. The differences were most pronounced among patients who received pre-operative radiation therapy and post-operative chemotherapy as well as in cases of metastasis spread into regional lymph nodes. The mechanism of the effect of the anaesthetic on the survival rates of cancer patients may be explained on the basis of the data available on the varying influences of anaesthetics on the pituitary-adrenal cortec system and carcinemia development during operation as well as the role of immunity in tumour cell implantation and growth of metastases.

Effects of halothane on the metabolism of human adipose tissue

The metabolism of specimens of human adipose tissue exposed to different concentrations of halothane was studied. Halothane was added to the incubation medium directly or via the gas phase above the medium. The basal lipolysis was significantly increased by low concentrations of halothane. Higher concentrations clearly diminished the lipolysis, but here, in spite of the inhibitory effect on the basal lipolysis, the lipolytic effect of noradrenaline expressed as percent increment was increased. The rate of lipid synthesis from glucose was reduced when halothane was present in the gas phase. The effect of insulin on glucose metabolism was not affected by the presence of halothane, while the antilipolytic action was abolished by high concentrations of halothane. The results show that halothane may exert dual effects on the mobilization of lipids from human adipose tissue; at low concentrations halothane enhances the basal lipolysis, while at higher concentrations it exerts inhibitory effects.

Effect of isoflurane anaesthesia and surgery on carbohydrate metabolism and plasma cortisol levels in man

The present study was undertaken to investigate in nine male surgical patients the effects of isoflurane anaesthesia alone on the carbohydrate metabolism by determining plasma growth hormone (GH), insulin, blood glucose, and cortisol, and to compare them with the effects of anaesthesia associated with surgical operations. Determination of plasma GH, insulin, cortisol, and blood glucose were made simultaneously before induction of isoflurane anaesthesia, after maintenance of anaesthesia for 15 minutes and 30 minutes and during and after conclusion of the operation. Plasma GH concentrations showed a significant elevation during isoflurane anaesthesia, and maintained a similar high level one hour after the start of the operation. An insignificant elevation in plasma insulin level and significant increases in blood glucose were noted during anaesthesia and operation. Plasma cortisol levels increased insignificantly during anaesthesia, but increased markedly during operation. Our observations would suggest that the increased blood level of GH and elevated blood cortisol play a part in the increase of blood glucose during isoflurane anaesthesia and surgical operations in man.