Summary
Vasoactive intestinal peptide (VIP) has a variety of extra-intestinal actions which
are typical of the body's reaction to stress, such as lipolysis, glycogenolysis and
modulation of anterior pituitary hormone secretion.
Serial VIP plasma concentrations in patients undergoing major laparotomies were determined.
The influence of the mu-receptor agonist, fentanyl, on intra-operative changes was
investigated and compared to a control group receiving halothane anesthesia. Plasma
levels of typical “stress hormones” cortisol and catecholamines were also monitored
for additional information on the extent of perioperative stress.
VIP levels increased intraoperatively in the halothane group from 5.9±4.6 to 15.3±5.3
pmol/l. Cortisol and catecholamine levels showed a similar increase. The intraoperative
VIP increase in the fentanyl group was significantly smaller: 3.5±1.9 to 7.3±3.6 pmol/l.
Anesthesia itself did not affect VIP concentrations as shown by constant levels during
a 30 minute preoperative control period.
The observed increases of VIP plasma concentration are thought to reflect a possible
role for VIP in the hormonal metabolic response to stress. The attenuation of the
increase by fentanyl might be due to a direct opiate action on VIP release.
Key-Words
VIP
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Cortisol
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Catecholamines
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Surgical Stress
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Opiates
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Halothane
