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전신마취하에서 실시한 외과적 자극이 코티솔 분비에 미치는 영향

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 Influences of surgical stress under general anesthesia on cortisol secretion in male and female patients 
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[한글] Halothane-N^^2 O 전신마취하에서 실시한 외과적 자극이 부실피질홀몬분비에 어떻게 영향을 미치는가를 보기 위하여 내분비계 질환을 갖고있지 않는 남성환자 8예, 가임여성환자 12예, 폐경환자 8예를 대상으로 마취전, 마취중,그리고 마취후에 cortisol치를 rad-in immnnoassay에 의하여 측정 비교하여 다음과 같은 결과를 얻었다. 1. 마취직전 cortisol치는 남자에 비하여 폐경부인에서 유의하게 증가하고 가임부인에서 약간의 증가를 보였다 2. 남자인 경우 혈청 cortisol치는 마취후 30분부터 시작하나 2시간, 5 ∼ 6시간후에 유의하게 증가하였으며 수술후 2일에 정상 기저치로 회복이 되었으며 7일에도 비슷한 유지하였다. 3. 폐경이된 부인에서는 마취후 30분부터 혈청 cortisol이 유의하게 급증하여 5∼6시간후까지 증가생태를 보이다가 수술후 2일과 7일에는 마취직전 cortisol치와 비교하여 현저하제 감소되었다. 4. 가임부인에서 마취전, cortisol치와 비교하여 볼 때 마취후 2시간까지는 혈청 cortisol이 유의하게 증가하지 않았으나 5∼6시간 후에는 현저히 증가되었다. 폐경여성의 경우에서와 같이 마취후 2일. 7일에는 마취전 cortisol치와 비교하여 유의하게 감소하였다 이상의 결과로 보아 전신마취하에서 시행한 외과적 자극은 마취중에만 남·녀 모든 환자에서 cortisol분비를 증가시킨다.
[영문] Effects of surgical stress under the general anesthesia with Halothane-N^^2 O-O^^2 on serum cortisol levels were studied in 8 postmenopausal female patients, 14 menstruating female patients and 8 male patients with no disorders of the endocrine systrm, liver or kidney functions as judged by routine tests. Control serum samples were taken immediately before anesthesia and subsequent samples were obtained from the patients 30 min. 1 and 5-6hrs after induction of anesthesia and on 2nd and 7th post-oprtative days. Concentration of serum contisol were measured by radioimmunoassay method. The results obtained are as follows: 1. Serum cortisol levels in preanesthetic period to serve as a control were significantly elevated in postmenopausal patients and slightly elevated menstruating female patients, as compared with those of male patients. 2. In male patients, serum cortisol levels started to increase form 30 min, after induction of anesthesia and at 2 hr, and 5-6 hr, increased significantly over thowe of pre-anesthesia. On the 2nd postoperative day, the cortisol levels returned toward the base line at preanesthetic period, maintaining similar levels at 7th postoperative day. 3. In postmenopausal patients, the serum cortisol concentration increased significantly over those of preanesthesia at 30 min, after induction of anesthesia, maintaining similar levels at 5-6 hr, postanesthesia. Significant decrease in serum cortisol levels were obtained on 2nd and 7th postoperative days, as compared with the levels at preanesthetic period, but these levels were within the normal range for normal cortisol value in our laboratory. 4. In mensturating female patients,no significant changes in serum cortisol levels were observed until 5- hr, after the induction of anesthesia, although slight increase in cortisol levels were shown before this time. On 2nd and 7th days, significant decrease in cortisol levels below those of preanesthesia were demonstrated, but these levels are within normal range of normal cortisol values in our labortatory. From the results mentioned above, it may be concluded that under general anesthesia with Halothane-N^^2 O-O^^2 significant intraoperative increase in serum cortisol levels occur in all male and female patients.
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