Abstract
In 14 patients who had elective gastrectomy, 50 mg of indomethacin was administered intrarectally every 6-8 hours after operation until postoperative day 3. Body temperature, plasma cortisol and glucagon concentrations, blood glucose level, urinary catecholamine level, and urinary nitrogen excretion level were compared with those of 16 patients who did not receive indomethacin. Postoperative fever was significantly reduced by indomethacin. Plasma cortisol levels in the indomethacin-treated group were significantly lower on postoperative days 2 and 3. Postoperative increases in plasma glucagon and blood glucose levels were not influenced by indomethacin administration. Urinary epinephrine excretion tended to be inhibited, and urinary norepinephrine excretion was significantly inhibited in the indomethacin-treated group after operation. Urinary nitrogen excretion levels during the observation period were significantly less in the indomethacin-treated group. The cumulative urinary nitrogen level from postoperative days 1-3 in the indomethacin-treated group was 82% of that in the control group. These results indicated that fever reduction by indomethacin after surgery resulted in reduced protein loss, associated with attenuated cortisol and catecholamine responses.
Full text
PDF






Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Baracos V., Rodemann H. P., Dinarello C. A., Goldberg A. L. Stimulation of muscle protein degradation and prostaglandin E2 release by leukocytic pyrogen (interleukin-1). A mechanism for the increased degradation of muscle proteins during fever. N Engl J Med. 1983 Mar 10;308(10):553–558. doi: 10.1056/NEJM198303103081002. [DOI] [PubMed] [Google Scholar]
- Bessey P. Q., Watters J. M., Aoki T. T., Wilmore D. W. Combined hormonal infusion simulates the metabolic response to injury. Ann Surg. 1984 Sep;200(3):264–281. doi: 10.1097/00000658-198409000-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Boonyaviroj P., Gutman Y. Inhibition by PGE2 and by phenylephrine of catecholamine release from human adrenal in vitro. Eur J Pharmacol. 1977 Jan 7;41(1):73–75. doi: 10.1016/0014-2999(77)90373-9. [DOI] [PubMed] [Google Scholar]
- Brandt M. R., Fernades A., Mordhorst R., Kehlet H. Epidural analgesia improves postoperative nitrogen balance. Br Med J. 1978 Apr 29;1(6120):1106–1108. doi: 10.1136/bmj.1.6120.1106. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Brody M. J., Kadowitz P. J. Prostaglandins as modulators of the autonomic nervous system. Fed Proc. 1974 Jan;33(1):48–60. [PubMed] [Google Scholar]
- Fletcher J. R. Prostaglandin synthetase inhibitors in endotoxin or septic shock--a review. Adv Shock Res. 1983;10:9–14. [PubMed] [Google Scholar]
- Freund H. R., James J. H., LaFrance R., Gallon L. S., Barcelli U. O., Edwards L. L., Joffe S. N., Bjornson H. S., Fischer J. E. The effect of indomethacin on muscle and liver protein synthesis and on whole-body protein degradation during abdominal sepsis in the rat. Arch Surg. 1986 Oct;121(10):1154–1158. doi: 10.1001/archsurg.1986.01400100062012. [DOI] [PubMed] [Google Scholar]
- Gelfand R. A., Matthews D. E., Bier D. M., Sherwin R. S. Role of counterregulatory hormones in the catabolic response to stress. J Clin Invest. 1984 Dec;74(6):2238–2248. doi: 10.1172/JCI111650. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Goldberg A. L., Baracos V., Rodemann P., Waxman L., Dinarello C. Control of protein degradation in muscle by prostaglandins, Ca2+, and leukocytic pyrogen (interleukin 1). Fed Proc. 1984 Apr;43(5):1301–1306. [PubMed] [Google Scholar]
- Hindawi R. K., Al-Dujaili E. A., Padfield P. L. The role of prostaglandins in aldosterone and corticosterone secretion by isolated perfused rat zona glomerulosa cells. Prostaglandins Leukot Med. 1985 Nov;20(2):121–128. doi: 10.1016/0262-1746(85)90002-2. [DOI] [PubMed] [Google Scholar]
- Imagawa K., Nishino T., Shin S., Uehata S., Hashimura E., Yanaihara C., Yanaihara N. Production of anti-glucagon sera with a C-terminal fragment of pancreatic glucagon. Endocrinol Jpn. 1979 Feb;26(1):123–131. doi: 10.1507/endocrj1954.26.123. [DOI] [PubMed] [Google Scholar]
- Kayaalp S. O., Türker R. K. Release of catecholamines from the adrenal medulla by prostaglandin E1. Eur J Pharmacol. 1967 Dec;2(3):175–180. doi: 10.1016/0014-2999(67)90083-0. [DOI] [PubMed] [Google Scholar]
- Kim Y. D., Lake C. R., Lees D. E., Schuette W. H., Bull J. M., Weise V., Kopin I. J. Hemodynamic and plasma catecholamine responses to hyperthermic cancer therapy in humans. Am J Physiol. 1979 Nov;237(5):H570–H574. doi: 10.1152/ajpheart.1979.237.5.H570. [DOI] [PubMed] [Google Scholar]
- Rolland P. H., Rolland A. M., Benkoel L., Toga M. Prostaglandins and steroidogenesis in isolated bovine adrenal cells. Effects of ACTH, prostaglandin-synthesis inhibitors, prostaglandins and prostaglandin analogs. Mol Cell Endocrinol. 1981 May;22(2):179–193. doi: 10.1016/0303-7207(81)90090-3. [DOI] [PubMed] [Google Scholar]
- Rowe D. J., Gedeon G., Broom J., Fleck A. The effect of indomethacin on the biochemical response to fracture stress in rats. Br J Exp Pathol. 1979 Dec;60(6):589–595. [PMC free article] [PubMed] [Google Scholar]
- Rowe D. J., Gedeon G. Reversal by prostaglandin E2 infusion of the effects of indomethacin on the excretion of nitrogenous compounds in the rat. Br J Exp Pathol. 1983 Jun;64(3):306–311. [PMC free article] [PubMed] [Google Scholar]
- Rutberg H., Håkanson E., Anderberg B., Jorfeldt L., Mårtensson J., Schildt B. Effects of the extradural administration of morphine, or bupivacaine, on the endocrine response to upper abdominal surgery. Br J Anaesth. 1984 Mar;56(3):233–238. doi: 10.1093/bja/56.3.233. [DOI] [PubMed] [Google Scholar]
- Shirasaka C., Tsuji H., Asoh T., Takeuchi Y. Role of the splanchnic nerves in endocrine and metabolic response to abdominal surgery. Br J Surg. 1986 Feb;73(2):142–145. doi: 10.1002/bjs.1800730224. [DOI] [PubMed] [Google Scholar]
- Swartz S. L., Williams G. H. Role of prostaglandins in adrenal steroidogenesis. Endocrinology. 1983 Sep;113(3):992–996. doi: 10.1210/endo-113-3-992. [DOI] [PubMed] [Google Scholar]
- Thompson M. E., Hedge G. A. Corticosterone secretion after inhibition of prostaglandin synthesis by indomethacin. Am J Physiol. 1981 Feb;240(2):E131–E135. doi: 10.1152/ajpendo.1981.240.2.E131. [DOI] [PubMed] [Google Scholar]
- Tsuji H., Asoh T., Takeuchi Y., Shirasaka C. Attenuation of adrenocortical response to upper abdominal surgery with epidural blockade. Br J Surg. 1983 Feb;70(2):122–124. doi: 10.1002/bjs.1800700223. [DOI] [PubMed] [Google Scholar]
- Tsuji H., Shirasaka C., Asoh T., Uchida I. Effects of epidural administration of local anaesthetics or morphine on postoperative nitrogen loss and catabolic hormones. Br J Surg. 1987 May;74(5):421–425. doi: 10.1002/bjs.1800740536. [DOI] [PubMed] [Google Scholar]
- Tsuji H., Shirasaka C. Inhibition of adrenergic response to upper abdominal surgery with prolonged epidural blockade. Jpn J Surg. 1982;12(5):344–348. doi: 10.1007/BF02469633. [DOI] [PubMed] [Google Scholar]
- Vane J. R. Inhibition of prostaglandin synthesis as a mechanism of action for aspirin-like drugs. Nat New Biol. 1971 Jun 23;231(25):232–235. doi: 10.1038/newbio231232a0. [DOI] [PubMed] [Google Scholar]
- Watters J. M., Bessey P. Q., Dinarello C. A., Wolff S. M., Wilmore D. W. Both inflammatory and endocrine mediators stimulate host responses to sepsis. Arch Surg. 1986 Feb;121(2):179–190. doi: 10.1001/archsurg.1986.01400020065008. [DOI] [PubMed] [Google Scholar]
- Weeke J., Gundersen H. J. The effect of heating and central cooling on serum TSH, GH, and norepinephrine in resting normal man. Acta Physiol Scand. 1983 Jan;117(1):33–39. doi: 10.1111/j.1748-1716.1983.tb07176.x. [DOI] [PubMed] [Google Scholar]
- Wilmore D. W. Are the metabolic alterations associated with critical illness related to the hormonal environment? Clin Nutr. 1986 Feb;5(1):9–19. doi: 10.1016/0261-5614(86)90037-3. [DOI] [PubMed] [Google Scholar]
- Yamashita K., Mieno M., Shimizu T., Yamashita E. Action of prostaglandin E2 on the release of catecholamines from the canine adrenal gland and its interaction with acetylcholine. J Endocrinol. 1978 Aug;78(2):249–254. doi: 10.1677/joe.0.0780249. [DOI] [PubMed] [Google Scholar]
