Opiate modulation of the stress-induced increase of vasoactive intestinal peptide (VIP) in plasma

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.