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Plasma cortisol levels in paediatric anaesthesia
Insights
Plasma cortisol levels in neonates did not change significantly during anesthesia. In infants, anesthesia increased cortisol, but halothane suppressed this rise.
Area of Science:
- Anesthesiology
- Pediatric Endocrinology
- Surgical Care
Background:
- Plasma cortisol levels are a key indicator of the stress response in infants and neonates.
- Understanding how anesthesia affects the hypothalamic-pituitary-adrenal (HPA) axis is crucial for pediatric surgical care.
Purpose of the Study:
- To investigate the impact of general anesthesia on plasma cortisol levels in neonates and infants.
- To compare the effects of anesthesia with and without halothane on cortisol response in infants.
Main Methods:
- Measurement of plasma cortisol levels during surgery in 7 neonates (≤10 days old).
- Measurement of plasma cortisol levels in 14 infants (3-11 months old) divided into two anesthesia groups: Group I (oxygen, nitrous oxide, muscle relaxant) and Group II (oxygen, nitrous oxide, halothane, muscle relaxant).
Main Results:
- No statistically significant changes in mean plasma cortisol levels were observed in neonates during anesthesia.
- In both infant groups, mean plasma cortisol levels increased during anesthesia.
- The initial rise in plasma cortisol levels was suppressed in infants who received halothane (Group II) compared to those who did not (Group I).
Conclusions:
- Neonates exhibit a stable plasma cortisol response to anesthesia.
- General anesthesia stimulates cortisol release in infants, indicating a stress response.
- Halothane administration during general anesthesia can attenuate the cortisol response in infants.
Abstract:
We measured plasma cortisol levels during surgery in seven neonates within ten days after birth and in 14 infants ranging in age from three months to 11 months. The 14 infants were divided into two groups; Group I included eight infants in whom general anaesthesia was maintained with oxygen, nitrous oxide and a muscle relaxant, Group II, six infants in whom general anaesthesia was maintained with oxygen, nitrous oxide, halothane and a muscle relaxant. In the neonates, the changes in mean plasma cortisol levels during anaesthesia were not statistically significant. In both Group I and Group II infants, the mean cortisol levels gradually rose during anaesthesia, but the initial rise in plasma cortisol levels was suppressed in the patients who received halothane.