[Hormonal changes during removal of aldosterone-producing adrenal tumor under sevoflurane anesthesia]

We measured plasma aldosterone, cortisol, ACTH and catecholamine concentrations during removal of aldosterone-producing adrenal tumor under sevoflurane anesthesia in four adult patients. Sevoflurane anesthesia alone did not affect the plasma levels of aldosterone, cortisol, ACTH and catecholamine. Plasma aldosterone levels increased significantly with surgical stimulation and reached the peak value before surgical manipulation. Thereafter they declined in magnitude and reached the value below the peanesthetic levels at recovery from anesthesia. Plasma cortisol and ACTH levels increased significantly with surgical stimulation, and plasma ACTH levels reached the peak values after the emergence from anesthesia in the recovery room. Plasma catecholamine levels increased with surgical stimulation, but the increase in plasma epinephrine levels was more striking than that in plasma norepinephrine levels during surgical manipulation of the tumor. Hypertension during manipulation of the tumor was demonstrated to correlate with increase in plasma epinephrine levels but not with plasma aldosterone levels. Sevoflurane gave us no trouble during anesthetic management for removal of aldosterone-producing adrenal tumor. We conclude that sevoflurane anesthesia is a better choice for surgery for primary aldosteronism.