Kudoh A, Ishihara H, Matsuki A. Inhibition of the cortisol response to surgical stress in chronically depressed patients.
J Clin Anesth 2000;
12:383-7. [PMID:
11025239 DOI:
10.1016/s0952-8180(00)00179-3]
[Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
STUDY OBJECTIVE
To evaluate whether the pituitary-adrenal and catecholamine response to surgical stress is modified in chronically depressed patients.
DESIGN
Prospective, controlled study.
PATIENTS
25 ASA physical status I and II depressed patients taking chronic antidepressant therapy and 25 control patients undergoing orthopedic surgery of the extremities.
INTERVENTIONS
All patients received anesthesia induction with thiopental 5 mg/kg and suxamethonium 1 mg/kg intravenously (IV) and were maintained with 1.5% to 2.0% isoflurane in nitrous oxide (70%) and oxygen (30%).
MEASUREMENTS AND MAIN RESULTS
Plasma cortisol concentration (27.7 +/- 3.6 microg/dL) in chronic depressed patients at 60 minutes after the skin incision was not significantly higher than that (23.9 +/- 2.7 microg/dL) before the induction, although plasma cortisol concentration in the control group significantly increased. Plasma norepinephrine concentration at 60 min after the skin incision in depressed patients with more symptoms of depression was significantly higher than that of patients with less symptoms of depression.
CONCLUSION
The cortisol response to surgical stress in depressed patients was inhibited and norepinephrine response to surgical stress was increased in depressed patients with more symptoms of depression.
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