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Canadian Journal of Anesthesia, Vol 46, 247-252, Copyright © 1999 by Canadian Anesthesiologists' Society

ARTICLES

Response to surgical stress in elderly patients and Alzheimer's disease

A Kudoh, H Ishihara and A Matsuki
Division of Anesthesia, Hakodate Watanabe Hospital, Japan.

PURPOSE: To determine the effect of surgical stress on plasma epinephrine, norepinephrine, ACTH and cortisol concentrations in patients aged 80-99 yr and in patients complicated with Alzheimer's disease. METHODS: A prospective controlled study was undertaken in 55 undergoing surgical reduction of femur neck fracture in Hirosaki University hospital and Hakodate Watanabe hospital; 18 patients in 80-99 yr (Group 1) and 18 patients in 40-59 yr (Group 2) and 7 patients (Group A) with and 12 patients (Group B) without Alzheimer's dementia (AD) aged 60-79 yr. RESULTS: The increase in plasma norepinephrine level (274%) of group 1 patients, 15 min after skin incision was higher than that in group 2 (191%) (P < 0.01). Mean plasma cortisol levels (40.4+/-4.7 and 44.1+/-5.2 microg x dl(-1)) of group 1, 15 min after skin incision and 60 min after the end of surgery were significantly higher than the 29.8+/-3.5 and 22.3+/-3.0 microg x dl(-1) of group 2 (P < 0.05). Plasma norepinephrine (1092.9+/-112.0 pg x ml(-1)) and cortisol concentrations (53.4+/-5.8 microg x dl(-1)) in group A were higher than in group B (772.6+/-82.4 pg x ml(-1) and 41.7+/-4.3 microg x dl(-1)) 15 min after skin incision (P < 0.05). CONCLUSIONS: Plasma norepinephrine and cortisol responses to surgical stress are activated in elderly patients and in patients with Alzheimer's disease.


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A. Kudoh, H. Katagai, and T. Takazawa
Endocrine response to surgical stress in three patients over 100 yr
Can J Anesth, April 1, 2001; 48(4): 340 - 343.
[Abstract] [Full Text] [PDF]


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Copyright © 1999 by the Canadian Anesthesiologists' Society.