J.Jpn. Surg. Soc.. 58(11): 1743-1767, 1958

---

SOME ASPECTS OF PITUITARY ADRENOCORTICAL FUNCTION DURING AND AFTER SURGICAL OPERATIONS

The investigation was carried out on 130 surgical patients during and after operations. Eosinophil, erythrocyte and leucocyte counts, G_B, G_P, Ht, Hb, urine volume, urinary 17-Ketosteroid excretion, serum and urine electrolyte level, water and salt balance, and adrenalin test were determined. These determinations were performed every 1/2 hours during anesthesia or operations and every 24 hours to 7 days after operations.
At the time of premedication or intubation of gas anesthesia the eosinophil counts, the urine volume, the urine sodium and chloride excretion depressed. And immediately after this fall, a transient rise (the first peak) to nearly normal level was found. And then these levels fell greatly and frequently we found the second peak during major operations.
Before the first peak the urine potassium excretion rose greatly and then fell, and during major operations we found the second increasing period. Postoperatively the urine potassium excretion decreased.
Usually the serum sodium and potassium levels were normal, but frequently during operations the serum sodium concentration was slightly low and during anesthesia the serum potassium concentration was high.
The fall in the number of circulating eosinophils, the urine volume and the urine sodium and potassium excretions continued to about 6~7 days or more later major operations.
The urinary 17-Ketosteroid excretion increased in patients undergoing major operations, but attention has been called to the individual variation.
In some surgical patients, demonstrating inadequate response to the adrenaline test, no eosinophil depression appeared during anesthesia or operations. But in these patients ACTH was administered parenterally typical eosinophil depression appeared.
Some analyses of the results on the stress response have been discussed in terms of their clinical implications. It is emphasized that more studies on hypophysial-adrenocortical system are needed before, during and after surgical operations.
(author's abstract)

---

---

To read the PDF file you will need Adobe Reader installed on your computer.