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Anesth Analg 1986; 65:1117-1122
© 1986 International Anesthesia Research Society
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Isoflurane Decreases the Cortisol Response to Cardiopulmonary Bypass

Paolo Flezzani, MD, Narda D. Croughwell, CRNA, R. William McIntyre, MD, and J. G. Reves, MD

Division of Cardiothoracic Anesthesiology, Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina.

Abstract

Eighteen patients with normal left ventricular function scheduled for elective myocardial revascularization were anesthetized with fentanyl (52–58 µg/kg). At the beginning of hypothermic cardiopulmonary bypass (CPB) they were assigned to a control (C) group (n = 6) that did not receive further anesthesia, or to a group either 1% isoflurane (n = 6) or 2% isoflurane (n = 6). Blood samples for measurement of total plasma cortisol concentration were obtained before, during, and after CPB. Hemodynamic measurements before and after CPB were not different among groups. Patients in group C required higher infusion rates of sodium nitroprasside (P ≤ 0.05) and patients given 2% isoflurane received more phenylephrine (P ≤ 0.05) to keep mean arterial pressure at 50 ± 10 mm Hg during CPB. Isoflurane caused a dose-related decrease in total plasma cortisol concentrations during and after CPB. We conclude that increased depth of anesthesia attenuates the cortisol (stress) response to cardiopulmonary bypass.

Key Words: ANESTHESIA—cardiovascular • HORMONES—cortisol • ANESTHETICS, INTRAVENOUS—fentanyl • ANESTHETICS, VOLATILE—isoflurane




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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 1986 by the International Anesthesia Research Society.