[Plasma cortisol levels during abdominal surgery under sevoflurane anesthesia: comparison between gastrointestinal...

Plasma cortisol levels during abdominal surgery under sevoflurane anesthesia were evaluated in 22 patients who ranged in ages from 37 to 65. They underwent either gastrointestinal or gynecological abdominal surgery. Anesthesia was induced and maintained with sevoflurane (1-5%) in nitrous oxide (4 l.min-1) and oxygen (2 l.min-1). Succinylcholine was administered intravenously to facilitate tracheal intubation and pancuronium was given intravenously during surgery. Lactated Ringer's solution at a speed of 10-15 ml.kg-1.hr-1 was also administered intravenously throughout the surgical procedures. Plasma cortisol levels were unchanged with the induction of sevoflurane anesthesia alone, but they increased significantly 2-3 times of the preanesthetic levels during and after surgery in both groups. However, the concentrations of plasma cortisol after recovery from anesthesia were significantly higher in the gastrointestinal group than in the gynecological group. The findings suggest that plasma cortisol levels after surgery reflect the difference in magnitude of stress response between gastrointestinal and gynecological surgery.