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British Journal of Anaesthesia, 1971, Vol. 43, No. 12 1136-1144
© 1971 The Board of Management and Trustees of the British Journal of Anaesthesia

other

PLASMA CORTISOL RESPONSES DURING NEUROSURGICAL AND ABDOMINAL OPERATIONS

J. G. LINES, M.A., M.SC., PH.D., M.R.C.path., R. E. LODER, M.A., M.B., B.CHIR., F.F.A.R.C.S. and R. A. MILLAR, M.D., M.SC., PH.D., F.F.A.R.C.S.*

Biochemical Section, John Bonnett Clinical Laboratories, Adden-brooke's Hospital Cambridge
Peterborough District Hospital Peterborough
Department of Anaesthetics, Addenbrooke's Hospital Cambridge

Plasma cortisol was measured in relation to neurosurgical or abdominal operations. In neurosurgical patients, the levels were insignificantly changed during light anaesthesia with nitrous oxide and halothane, after thiopentone induction. Plasma cortisol was not significantly changed in the course of thirteen major craniotomies although there were pronounced elevations in three patients with space-occupying lesions. At the end of intracranial surgery, when anaesthesia was being discontinued, the mean cortisol level was significantly higher than before induction of anaesthesia. Pre-operative administration of betamethasone resulted in low plasma cortisol levels, which showed no change over the operative period. In contrast, abdominal exploration evoked substantial rises in plasma cortisol, which were similar whether or not a parasympathetic-type circulatory response occurred. Hydrocortisone 100 mg was injected before abdominal surgery in some patients and raised plasma cortisol to levels far higher than those caused by intra-abdominal manipulation.

*Present address: Division of Anaesthesia, Clinical Research Centre, Watford Road, Harrow, Middlesex.


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