Plasma Levels of ACTH and Cortisol in Man during Diethyl Ether Anesthesia and Surgery

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Abstract
Levels of ACTH in the peripheral plasma of 10 patients during ether anesthesia alone and during and after laparotomy were determined by a modification of Lipscomb and Nelson''s bioassay method. Levels of free cortisol in the plasma were determined simultaneously. Results of pituitary-adrenocortical reserve tests of all patients in the preanesthetic period were within normal limits. Plasma ACTH levels were very low (estimated less than 1 mU/100 ml). A remarkable increase of pituitary-adrenocortical activity was noted during anesthesia, which was induced and maintained with diethyl ether-nitrous oxide at a depth of plane 2-3 of stage III. During induction of anesthesia and during surgery large amounts of ACTH were released intermittently, with 2 or 3 steep peaks in the plasma levels. In contrast, the level of free cortisol in the plasma rose gradually. Our data indicate that the increased levels of free cortisol in the plasma were the result of increased plasma ACTH activity.