Both alcohol drinking and depression are risk factors for postoperative confusion and are associated with alteration of pituitary-adrenal function. We investigated the incidence of postoperative confusion, plasma cortisol and ACTH response to surgical stress in depressed patients with alcohol abuse. We studied sixty depressed patients with and without alcohol abuse who underwent abdominal surgery. Postoperative confusion occurred in 4 of 30 patients (13%) in depressed patients without alcohol abuse, 10 of 30 patients (33%) in depressed patients with alcohol abuse. Plasma cortisol concentrations (27.2 ± 7.0, 28.3 ± 8.2, 29.2 ± 4.1, 28.0 ± 6.3 and 27.9 ± 5.7 µg dl–1) 15, 60 min after the skin incision, 60 min after the end of surgery, the next day and the third day after surgery in depressed patients with alcohol abuse were significantly higher than that (20.1 ± 6.4, 21.7 ± 9.6, 22.3 ± 8.0, 21.9 ± 6.7 and 20.3 ± 5.4 µg dl–1) in depressed patients without alcohol abuse. In depressed patients with alcohol abuse, plasma cortisol concentrations (34.9 ± 7.1, 33.2 ± 5.8 and 33.4 ± 5.5 µg dl–1) 60 min after the end of surgery, the next day and third day after surgery in postoperatively confused depressed patients were significantly higher than those (26.4 ± 6.3, 25.4 ± 5.0 and 25.2 ± 4.9 µg dl–1) of nonconfused depressed patients. In conclusion, the incidence of postoperative confusion was significantly higher in depressed patients with alcohol abuse than in depressed patients without alcohol abuse. Increased plasma cortisol concentrations after surgery were associated with postoperative confusion in depressed patients with alcohol abuse.

This content is only available via PDF.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.