The Influence of Induction Anesthetic Agents on Serum Cortisol Concentration in Morbidly Obese Patients.
Status:
Completed
Trial end date:
2011-07-01
Target enrollment:
Participant gender:
Summary
The effect of etomidate administration on the adrenal cortex in obese patients is still
unclear. The objective of the study was to determine the influence of single dose of
etomidate on cortisol secretion in morbidly obese. The participants were divided equally into
etomidate and thiopental groups, depending on kind of intravenous anesthetic used for
induction of anesthesia.
Healthy patients in ASA class I and II awaiting elective abdominal laparoscopic surgery were
included in the study. The participants were initially divided into two groups: the first
group included patients with morbid obesity (BMI > 40), and the second group included
patients with normal body weight (BMI < 25). All the patients inside the two groups were
subsequently randomly and divided into etomidate and thiopental groups, according to the
intravenous anesthetic used as the induction agent for general anesthesia. Finally, four
groups of patients were analyzed: 1. obese, in which etomidate was used (OE group), 2. obese,
in which thiopental was used (OT group), 3. patients with normal body mass, in which
etomidate was used (NE group), and 4. patients with normal body mass, in which thiopental was
used (NT group).
The patients excluded from the study were those who: 1. did not agree to participate, 2. were
treated with steroidal drugs, 3. had cortisol metabolism disorders or were treated with drugs
with a potential impact on serum cortisol concentration, 4. had a preoperative risk
assessment result of ASA class III, IV and V, 5. had an initial surgical laparoscopic
technique converted to laparotomy, and 6. had surgical complications increasing the level of
intraoperative stress.