Hypothalamic–pituitary–adrenal function: anaesthetic implications

Surgery, trauma and critical illness evoke a series of hormonal and metabolic changes commonly referred to as the stress response. Activation of the hypothalamic–pituitary–adrenal axis results in increased secretion of hormones such as cortisol. Anaesthesia can suppress adrenocortical secretion either by an effect at the hypothalamus, for example by a decrease in neural input with regional anaesthesia, or by a direct effect on the adrenal cortex, for example by etomidate. For patients undergoing routine surgery an increase in cortisol secretion is unnecessary, uneventful recovery occurs in the presence of circulating cortisol concentrations within the normal range.
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Authors: Tags: Pharmacology Source Type: research