Summary
Effects of gallamine on plasma cortisol and catecholamine concentrations were studied in ten elective surgical patients. A total of 200 mg of gallamine in divided doses was administered intravenously to each patient prior to start of the operation. Maintenance of anaesthesia was with halothane-nitrous oxide-oxygen. Hypoxia and hypercarbia were not allowed to occur, as substantiated by blood gas determinations.
Until 20 minutes after induction, no significant changes from base line were observed in plasma cortisol concentrations. A significant increase was observed at 30 minutes following induction and before the operation had started (p<0.05) This pattern is similar to those observed previously with succinylcholine chloride and dialyl-nor-toxiferine.
Significant elevations of free norepinephrine concentrations were observed at two minutes (p<0.05) and five minutes (p<0.025) following the initial intravenous dose of 40 to 80 mg of gallamine. However, no alteration was found in free plasma epinephrine. It is concluded, therefore, that gallamine is likely to cause the release of free norepinephrine from sympathetic nerve endings.
Résumé
Chez dix candidats à de la chirurgie élective, nous avons étudié les effets de la gallamine sur les concentrations des catecholamines et du cortisol plasmatiques. A chacun des malades, avant le début de l'opération, nous avons donné, par voie endoveineuse, en doses fractionnées, un total de 200 mgs de gallamine. Le maintien de l'anesthésie s'est fait avec de l'halothane, du protoxyde d'azote et de l'oxigène. Nous avons évité l'hypoxie et l'hypercabie comme le prouvent les résultats des gaz artériels.
Jusqu'a vingt minutes après l'induction, nous n'avons pas observé de changement des taux de cortisol plasmatique. Trente minutes après l'induction, avant le début de la chirurgie, nous avons noté une augmentation significative (p<0.05). Cette allure est semblable à celles observées antérieurement avec le chlorure de succinylcholine et le dialyl-nor-toxiferine.
Nous avons trouvé une augmentation importante des concentrations de norephinephrine ibre à deux minutes (p<0.05) à 5 minutes (p<0.025) après une dose initiale par voie endoneineuse de 40 à 80 mgs de gallamine. Toutefois, nous n'avons pas noté de modification du taux d'épinéphrine plasmatique libre. En conséquence, nous concluons que, selon toute vraisemblance, la gallamine provoque la libération de nor-epinephrine libre des terminaisons nerveuses sympathiques.
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References
Astrup, P., Jørgensen, K., Siggard-Anderson, O., &Engel, K. The acid-base metabolism, a new approach. Lancet1: 1035–1039 (1960).
Brown, B.R. &Crout, J.R. Mechanism of the positive inotropic effect of gallamine on guinea pig heart muscle. Fed. Proc.25: 472 (1966).
Brown, B.R. &Crout, J.R. The sympathomimetic effect of gallamine on the heart. Anesthesiology29: 179–180 (1968).
Brunt, E.E. &Ganong, W.F. The effects of preanesthetic medication, anesthesia and hypothermia on the endocrine response to injury. Anesthesiology24: 500–514 (1963).
Castognoli, Jr.,N., Goldfine, A., &Ganong, W.F. Release of adrenal steroids during asphyxia. Fed. Proc.20: 178 (1961).
Condon, H.A. The clinical use of Flaxedil Anaesthesia6: 92–95 (1951).
Done, A.K., Ely, R.S., &Kelly, V.C. Studies of 17-hydroxycorticosteroids. Amer. J. Dis. Child.96: 655–665 (1958).
Eisele, J.H., Marsa, J.A., &Davis, H.S. Quantitative aspects of the chronotropic and neuromuscular effects of gallamine in anesthetized man. Anesthesiology35: 630–633 (1971).
Kelsch, R.C., Light, G.S., Luciano, J.R., &Oliver, W.J. The effects of Prednisone on plasma norepinephrine concentration and renin activity in salt-depleted man. J. Lab. Clin. Med.77: 267–277 (1971).
Matsuki, A., Sato, K., &Oyama, T. Effects of muscle relaxant on adrenocortical function during halothane anesthesia in man. Agressologie12: 149–155 (1970).
Matsuki, A. &Oyama, T. Adrenocortical function related to administration of muscle relaxants during halothane anesthesia in man. Agressologie12: 283–289 (1971).
Migeon, C.J., Tyler, F.H., Mahoney, J.P., Florentine, A.A., Gastle, H., Bliss, E.L., &Samuels, L.T. The diurnal variation of 17-hydroxycorticosteroids in normal subjects. J. Clin. Endocri.16: 622–633 (1956).
Oyama, T., Saito, T., Isomatsu, T., Samejima, N., Uemura, T., &Arimura, A. Plasma levels of ACTH and cortisol in man during ether anesthesia and surgery. Anesthesiology29: 559–564 (1968).
Oyama, T., Shibata, S., Matsumoto, F., Takiguchi, M., &Kudo, T. Effects of halothane anesthesia and surgery on adrenocortical function in man. Canad. Anaes. Soc. J.15: 258–266 (1968).
Oyama, T., Matsumoto, F., &Kudo, T. Effect of ketamine on adrenocortical function in man. Anes. Analg.49: 697–700 (1970).
Oyama, T., Shibata, S., Matsumoto, F., Matsuki, A., Kimura, K., Takazawa, T., &Kudo, T. Adrenocortical function related to methoxyflurane anesthesia and surgery in man. Canad. Anaes. Soc. J.15: 362–368 (1968).
Oyama, T., Takiguchi, M., Aoki, N., &Kudo, T. Adrenocortical function related to thiopental-nitrous oxide-oxygen anesthesia and surgery in man. Anes. Analg.50: 727–731 (1971).
Price, H.L., Linde, H.W., Jones, R.E., Black, G.E., &Price, M.L. Sympathoadrenal responses to general anesthesia in man and their relation to hemodynamics. Anesthesiology20: 563–575 (1959).
Rathbun, F.J. &Hamilton, J.T. Effects of gallamine on cholinergic receptors. Canad. Anaes. Soc. J.17: 574–590 (1970).
Riker, W.F. &Wescoe, W.C. The pharmacology of Flaxedil, with observations on certain analoges. Amer. N.Y. Acad. Sci.54: 373–394 (1957).
Rudd, B.T., Cowper, J.M. &Crawford, N. The determination of plasma free hydrocortisone and corticosterone by a combined fluorimetric and modified Poter-Silber procedure. Clin. Chem. Acta.6: 686–695 (1961).
Smith, N.T. &Whitcher, C.E. Hemodynamic effects of Gallamine and Tubocurarine administered during halothane anesthesia. J.A.M.A.199: 704–708 (1967).
Walton, F.A. Flaxedil: a new curarizing agent. C.M.A.J.63: 123–129 (1950).
Zsigmond, E.K., Kelsch, R.C. & Kothary, S.P. Plasma free norepinephrine concentrations during induction with ketamine. Unpublished.
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Matsuki, A., Kothary, S.P., Szigmond, E.K. et al. Effects of gallamine on plasma cortisol and catecholamine levels in man. Canad. Anaesth. Soc. J. 20, 539–545 (1973). https://doi.org/10.1007/BF03026215
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DOI: https://doi.org/10.1007/BF03026215