肾上腺病病人手术的麻醉（Anesthesia for surgery in patients with adrenal diseases）.docVIP

肾上腺病病人手术的麻醉（Anesthesia for surgery in patients with adrenal diseases） The effect of first anesthesia and operation on adrenal cortical function Cortisol is the most sensitive hormone to irritability, even if preoperative anxiety and anxiety can cause cortisol secretion to increase. Studies have shown that cortisol levels are high in the morning after surgery. Commonly used preoperative drugs such as sedatives, barbiturates or benzodiazepines, two benzodiazepines, analgesics, morphine, or pethidine help reduce cortisol secretion. Ether anesthesia increased the cortisol concentration, and after 30 min inhalation, the plasma cortisol concentration was increased from 15.6ug/dl-24.1ug/dl. The use of Nitrous Oxide alone also keep healthy cortisol concentration increased, while the other commonly used anesthetics, enflurane and isoflurane have inhibitory effect on adrenocortical function, can inhibit the secretion of cortisol increased. Common intravenous anesthetics such as droperidol, fentanyl, and diltiazem have little effect on adrenocortical function. But ketamine and gamma gamma hydroxybutyrate can increase plasma cortisol concentration. At low temperature, the stress response of the pituitary adrenal gland was suppressed and the secretion of cortisol decreased. The function of adrenal cortex was not changed by intraspinal anesthesia, and there were no significant changes in plasma endothelin, aldosterone and aldosterone. Different anesthesia prescription has different effect on plasma cortisol, such as droperidol and fentanyl combined with Nitrous Oxide 0.15mg/kg 3ug/kg 45 minutes after anesthesia, fentanyl 5ug/kg, plasma cortisol changed little, but 0.15mg/kg droperidol, pentazocine 1mg/kg and Nitrous Oxide and plasma cortisol was significantly increased, increased from 12.3ug/dl to 20.1ug/dl. Surgical trauma is a more severe stimulus than anesthesia, In particular, some major surgery and extensive burns can cause significant endocrine responses. Cortisol, aldoster