beta-endorphin and Respiration-Disorders

The effects of analgesia on plasma beta-endorphin (beta-E), serum cortisol and blood glucose responses were investigated in 20 distressed, mechanically ventilated neonates during the first 3 days of life. Morphine 0.1 mg/kg, meperidine 1 mg/kg or alfentanil 10 micrograms/kg were used for analgesia as clinically indicated. Plasma beta-E, serum cortisol and blood glucose were recorded before analgesia and 1 and/or 2, 12 and 24 h afterwards in the distress group and once in 20 healthy neonates (control group). beta-E, cortisol, and blood glucose before analgesia were significantly higher in the distress group than in the control group. Cortisol values had decreased significantly 2 h after analgesia and blood glucose within 12 h. Plasma beta-E values had decreased to the same level as in the controls 24 h after the start of analgesia. The results indicate that the stress response in the distressed neonates with cardiorespiratory problems, as assessed by beta-E, cortisol, and blood glucose, is attenuated by opioid medication, and it is concluded that these patients should be given adequate analgesia.

Topics: Analgesia; Apgar Score; Asphyxia Neonatorum; beta-Endorphin; Blood Glucose; Cardiovascular Diseases; Gestational Age; Heart Defects, Congenital; Humans; Hydrocortisone; Infant, Newborn; Persistent Fetal Circulation Syndrome; Respiration Disorders; Respiratory Distress Syndrome, Newborn

The effects of intrauterine stress and birth asphyxia on the plasma concentration of beta-endorphin (beta-E) in cord blood and in venous blood at the age of 2 h was investigated in newborn infants. Term infants with acute birth asphyxia (n = 11), infants born to mothers with preeclampsia (n = 15), and prematures with respiratory difficulties (n = 4) were entered into the study. Twenty control infants were studied; 12 were born after spontaneous delivery and eight after elective cesarean section. After normal spontaneous delivery, the plasma beta-E level decreased significantly, the median values being 17 pmol/liter at birth and 9.3 pmol/liter at the age of 2 h, whereas after elective cesarean section it remained unchanged (13 and 13 pmol/liter, respectively). In acute asphyxia the plasma beta-E level varied widely at birth, from 9.7 to 108 pmol/liter. At the age of 2 h, the beta-E level was high (26 to 83 pmol/liter) in those asphyctic infants who required prolonged mechanical ventilation, but it fell to the range of 1.6-13 pmol/liter when the infant recovered rapidly. The beta-E level was not increased in the preeclampsia group, not even in small for gestational age infants. In preterm newborn infants with respiratory difficulties, a significant postnatal rise of plasma beta-E level was found, the beta-E value varying from 7.3 to 16 pmol/liter at birth and from 61 to 168 pmol/liter at the age of 2 h. These results indicate that increased beta-E secretion is associated with respiratory difficulties in the newborn infant.

Topics: Apgar Score; Asphyxia; beta-Endorphin; Endorphins; Female; Fetal Blood; Gestational Age; Humans; Infant, Newborn; Infant, Newborn, Diseases; Placental Insufficiency; Pregnancy; Respiration Disorders

Beta-endorphin-like immunoreactivity was determined in the plasma of twenty patients suffering from hypoxia of various etiologies and in twenty healthy adult volunteers who served as controls. Mean beta-endorphin-like immunoreactivity in the hypoxic patients was 53.2 +/- 5.5 (SEM) pg/ml, as compared to the volunteer subjects in whom the mean level was 6.2 +/- 1.9 pg/ml (P less than 0.01). Significant negative correlations were present between both arterial pH (r = -0.85; P less than 0.01) and arterial PO2 (r = -0.80; P less than 0.01) and beta-endorphin-like immunoreactivity. These findings seem to lend support to the hypothesis that hypoxia and acidosis represent stressful conditions which may stimulate the release of beta-endorphin in humans.

Topics: Acidosis, Respiratory; Adult; beta-Endorphin; Endorphins; Humans; Hypoxia; Male; Radioimmunoassay; Respiration Disorders