Influence of propofol and methohexitone anesthesia on the cortisol response to surgery

The effect of two intravenous hypnotics, propofol and methohexitone, on cortisol secretion was evaluated in two groups of 40 women during minor fertility surgery. Both hypnotics were administered as constant rate infusions for 45 min in the presence of nitrous oxide. Blood samples for cortisol measurement were taken before induction and 30 minutes after the surgery. Both groups had similar cortisol levels preoperatively (propofol: 168 +/- 77 ng/ml, methohexitone: 159 +/- 76 ng/ml). Postoperatively, there was a significant reduction of plasma cortisol in the propofol group (117 +/- 55 ng/ml; P < 0.02) while there was no change in the methohexitone group (189 +/- 74 ng/ml). This observation may indicate a more profound reduction in central noradrenergic activity during propofol anesthesia.