Seitz W, Fritz K, Lübbe N, Grambow D, Kirchner E
Anasth Intensivther Notfallmed. 1985 Jun;20(3):125-30.
The effects of anaesthesia with fentanyl and prolonged etomidate infusion (0.8 mg/kg/h) on the peroperative and postoperative change in blood concentrations of aldosterone, cortisol, dehydroepiandrosterone, ACTH, epinephrine, norepinephrine, dopamine, glucose, lactate and free fatty acids (FFA) were investigated in connection with major abdominal surgery. During surgery and anaesthesia with prolonged etomidate infusion no significant alterations in plasma catecholamine concentrations were observed. In contrast, basal plasma levels of ACTH (20.0 +/- 9.5 pg/ml----352.8 +/- 150.8 pg/ml) were elevated in all patients. Despite this endogenous ACTH stimulus, aldosterone (121.8 +/- 19.4 pg/ml----58.4 +/- 10.4 pg/ml) and cortisol (12.3 +/- 2.84 micrograms/dl----5.79 +/- 1.2 micrograms/dl) and dehydroepiandrosterone (2.28 +/- 1.09 ng/ml----1.27 +/- 0.25 ng/ml) levels were markedly depressed in every patient during the perioperative period. Twenty-four hours after surgery the basal steroid values were within or above normal limits.
在腹部大手术中，研究了芬太尼麻醉和长时间输注依托咪酯（0.8mg/kg/h）对围手术期和术后醛固酮、皮质醇、脱氢表雄酮、促肾上腺皮质激素（ACTH）、肾上腺素、去甲肾上腺素、多巴胺、葡萄糖、乳酸和游离脂肪酸（FFA）血浓度变化的影响。在长时间输注依托咪酯进行手术和麻醉期间，未观察到血浆儿茶酚胺浓度有明显变化。相反，所有患者的ACTH基础血浆水平（20.0±9.5pg/ml----352.8±150.8pg/ml）均升高。尽管有这种内源性ACTH刺激，但在围手术期每位患者的醛固酮（121.8±19.4pg/ml----58.4±10.4pg/ml）、皮质醇（12.3±2.84μg/dl----5.79±1.2μg/dl）和脱氢表雄酮（2.28±1.09ng/ml----1.27±0.25ng/ml）水平均显著降低。术后24小时，基础类固醇值在正常范围内或高于正常范围。
