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Anesthesia and analgesia · Apr 2017
ReviewThe Hypothalamic-Pituitary-Adrenal Axis and Anesthetics: A Review.
- Emmanuel Besnier, Thomas Clavier, and Vincent Compere.
- From the *Department of Anesthesiology and Critical Care, Rouen University Hospital, Rouen, France; †Inserm U1096 New Pharmacological Targets of Endothelial Dysfunction and Heart Failure; and ‡Inserm U982 Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Institute for Research and Innovation in Biomedicine, Normandie University, Rouen, France.
- Anesth. Analg. 2017 Apr 1; 124 (4): 1181-1189.
AbstractThe hypothalamic-pituitary-adrenal (HPA) axis is essential for human adaptation to stress. However, many anesthetic agents may interfere with the activity of this axis. Although etomidate is known for its suppressive effect on HPA axis function, in vitro evidence suggests that many other drugs used in anesthesia care may also interfere with HPA activity. In this review, we discuss the mechanisms by which all HPA axis activity may be altered during anesthesia and critical care and focus on the impact of hypnotic and analgesic drugs.
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