Rodríguez-Huertas F, Carrasco M S, García-Baquero A, Coq F D, Freire J
Servicio de Anestesiología, Hospital del SAS. Jerez, Facultad de Medicina, Cádiz.
Rev Esp Anestesiol Reanim. 1992 May-Jun;39(3):145-8.
Benzodiazepines relieve anxiety and modify the endocrine response to surgical-anesthetic stress.
The aim of this study was to evaluate the effects of four benzodiazepines on preoperative secretion of cortisol and ACTH.
We studied 60 patients programmed for abdominal surgery. Patients were randomly allocated into six groups of treatment: control group (placebo), diazepam 10 mg, triazolam 0.5 mg, alprazolam 0.5 mg, bromazepam 6 mg, and bromazepam 12 mg. Blood samples for cortisol and ACTH measurements were obtained at five different stages of the anesthetic-surgical procedure: baseline, preanesthesia, anesthesia, surgery, and postoperative phase.
Diazepam and bromazepam (6 and 12 mg) lessened the increase in plasmatic cortisol induced by preanesthesia and anesthesia in control patients. Triazolam attenuated the cortisol response only during preanesthesia. Administration of 12 mg of bromazepam decreased ACTH levels during preanesthesia and anesthesia with respect to the control group.
Benzodiazepines failed to modify cortisol and ACTH levels during surgery and during the immediate postoperative period. The most marked attenuation of adrenocortical response was achieved with 12 mg of bromazepam and the less marked lessening was induced by 0.5 mg of alprazolam.
苯二氮䓬类药物可缓解焦虑，并改变机体对手术麻醉应激的内分泌反应。
本研究旨在评估四种苯二氮䓬类药物对术前皮质醇和促肾上腺皮质激素分泌的影响。
我们研究了60例计划接受腹部手术的患者。患者被随机分为六组进行治疗：对照组（安慰剂）、地西泮10毫克、三唑仑0.5毫克、阿普唑仑0.5毫克、溴西泮6毫克和溴西泮12毫克。在麻醉-手术过程的五个不同阶段采集血样以测定皮质醇和促肾上腺皮质激素：基线期、麻醉前、麻醉期、手术期和术后阶段。
地西泮和溴西泮（6毫克和12毫克）减轻了对照组患者麻醉前和麻醉期引起的血浆皮质醇升高。三唑仑仅在麻醉前减弱了皮质醇反应。与对照组相比，给予12毫克溴西泮可降低麻醉前和麻醉期的促肾上腺皮质激素水平。
苯二氮䓬类药物未能改变手术期间和术后即刻的皮质醇和促肾上腺皮质激素水平。12毫克溴西泮对肾上腺皮质反应的减弱最为显著，而0.5毫克阿普唑仑引起的减弱则最不明显。
