The alcoholic patient and surgical stress

In order to find out how the response to operative trauma is influenced by chronic alcohol consumption, 53 patients (28 alcoholics and 25 non-alcoholics) were investigated. The chronic alcoholic was defined as a person having a regular, daily alcohol consumption of over 70 g pure alcohol for at least 3 years. The mean annual consumption in the patients studied was 52 litres pure alcohol (143 ml/day). The investigation was also designed to determine whether the pre-operative infusion of alcohol could prevent the withdrawal syndrome and in that way alter the stress response. The results clearly showed a diminished adrenocortical response to surgical stress in alcoholic patients. While it was possible to suppress some catecholamine-mediated withdrawal symptoms by pre-operative alcohol infusion this did not influence the stress response in any way. It is concluded that complications under anaesthesia and in convalescence in alcoholic patients are not only the consequence of the withdrawal but rather of the general toxic effects of alcohol especially on the endocrine and metabolic functions.