[Effects of modified NLA with droperidol and eptazocine and surgery on pituitary-adrenocortical function in man]

Effects of modified NLA with droperidol + eptazocine on pituitary-adrenocortical function were evaluated in ten patients who received abdominal hysterectomy. They were premedicated adequately. The induction of anesthesia was started with eptazocine 30 mg iv and thiopental 3-4 mg.kg-1 iv and the trachea was intubated smoothly following succinylcholine 40 mg iv. Then, they were given intravenous droperidol 0.15 mg.kg-1 with inhalation of 70% N2O and 30% O2. Good intraoperative muscle relaxation was obtained by dialferine or pancuronium. Five ml of the venous blood was taken on six occasions as follows; before the anesthetic induction, 5 and 30 minutes after the induction, 30 and 60 minutes after the start of surgery and finally at full recovery from anesthesia in the recovery room. The blood samples were immediately centrifuged and the plasma was separated and stored at -20 degrees C until measurement. Plasma cortisol, ACTH, human growth hormone (HGH) and prolactin (PRL) were measured for evaluation of the anterior pituitary-adrenocortical function. No significant increase in plasma levels of cortisol, ACTH and HGH were observed during anesthesia alone, but they increased significantly during surgery. Plasma levels of PRL increased significantly soon after the induction. These results were similar to those of other neuroleptic anesthesia. The systemic blood pressure and the heart rate were stable during anesthesia and surgery, and plasma eptazocine concentration determined by GC-MS showed that effective concentrations of eptazocine were maintained during surgery. These data suggest that modified NLA with droperidol and eptazocine would deserve a further detailed clinical study.