The Cut-downing Effect of Vitamin C on Erythrocyte Sedimentation Rate and Adrenocortical Effects of Etomidate in Patients Undergoing Laparotomy Surgery: A Randomized Clinical Trial

OBJECTIVE: Suppression of the adrenocortical axis is the most disreputable side effect in patients who undergo mechanical ventilation and continuously sedated with etomidate. The objective of this study was to evaluate the effectiveness of Vitamin C in mitigating adrenal gland dysfunction caused by etomidate administration in surgical patients. MATERIALS AND METHODS: A randomized clinical trial was conducted on 100 participants, who were evenly divided into two groups: one receiving Vitamin C and the other serving as the control group. One hour before induction of surgery, the Vitamin C group received an infusion of 1 g of Vitamin C diluted in 500 ml of 5% dextrose solution and the control group received an infusion of 500 ml of 5% dextrose solution. Etomidate was applied for induction of patients in both the groups. Two different blood samples were prepared from patients, 5 min before and 4 h after induction with etomidate. Serum aldosterone, renin, and erythrocyte sedimentation rate (ESR) were measured. RESULTS: No significant changes were noted in blood pressure, heart rate, or oxygen saturation between the two groups before and after the surgical procedure ( P > 0.05). However, in the Vitamin C group, postoperative measurements revealed a significant reduction in serum aldosterone, renin, and ESR levels ( P < 0.001). While, in the Vitamin C group, po stoperative measurements revealed a significant reduction in serum aldosterone, renin, and ESR levels ( P < 0.001), the control group showed no significant variations in these parameters ( P > 0.05). CONCLUSION: Administration Vitamin C cannot prevent adrenal destruction via etomidate induction in patients with elective laparotomy, but it showed a cut-down effect in ESR, serum renin, and aldosterone after operation in the intervention group. Due to the difference observed in the results of various studies, it is considered that further research is needed.