Effects of indomethacin on endocrine responses and nitrogen loss after surgery

In 14 patients who had elective gastrectomy, 50 mg of indomethacin was administered intrarectally every 6-8 hours after operation until postoperative day 3. Body temperature, plasma cortisol and glucagon concentrations, blood glucose level, urinary catecholamine level, and urinary nitrogen excretion level were compared with those of 16 patients who did not receive indomethacin. Postoperative fever was significantly reduced by indomethacin. Plasma cortisol levels in the indomethacin-treated group were significantly lower on postoperative days 2 and 3. Postoperative increases in plasma glucagon and blood glucose levels were not influenced by indomethacin administration. Urinary epinephrine excretion tended to be inhibited, and urinary norepinephrine excretion was significantly inhibited in the indomethacin-treated group after operation. Urinary nitrogen excretion levels during the observation period were significantly less in the indomethacin-treated group. The cumulative urinary nitrogen level from postoperative days 1-3 in the indomethacin-treated group was 82% of that in the control group. These results indicated that fever reduction by indomethacin after surgery resulted in reduced protein loss, associated with attenuated cortisol and catecholamine responses.