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2008 | 3 | 4 | 459-463
Tytuł artykułu

Serum levels of cortisol and prolactin in patients treated under total intravenous anesthesia with propofol-fentanyl and under balanced anesthesia with isoflurane-fentanyl

Treść / Zawartość
Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
The study was designed to determine pre-, intra-and postoperative serum cortisol and prolactin (PRL) concentrations in patients subjected to low abdominal surgery under total intravenous anesthesia (TIVA) with propofol-fentanyl, and under general balanced anesthesia with isoflurane-fentanyl. The prospective study included 50 patients of both sexes, aged between 35 and 60 years, subjected to elective low abdominal surgery. Patients were randomly divided into two groups: an experimental group, consisting of 25 ASA I/II (American Society of Anesthesiologists I/II classification) patients treated under TIVA with propofol-fentanyl, and a control group consisting of 25 ASA I/II patients treated under balanced anesthesia with isoflurane-fentanyl. The length of the surgery and the degree of the surgical trauma did not differ significantly between the two anesthesia groups. Blood samples for cortisol and PRL measurements were drawn at exact time points: 30 minutes before the beginning of the surgery (T0), 30 minutes after the beginning of the surgery (T1), at the end of the surgery (T2), 2 hours after the surgery (T3), and 24 hours after the surgery (T4). Serum levels of cortisol and PRL were measured using commercially available kits. The results were evaluated with the nonparametric Mann-Whitney test. The serum concentration of cortisol measured at T1 time point in patients treated under TIVA was significantly lower (p=0.04) than that in patients treated under general balanced anesthesia. The average circulating levels of PRL measured at T1, T2 and T3 time points in patients treated under TIVA were significantly lower (p=0.003; p=0.002; p<0.05; respectively) than those in patients treated under balanced anesthesia. The results obtained suggest that the endocrine stress response developed in response to surgery is probably attenuated in patients treated under TIVA with propofol-fentanyl and, thus, that these patients are less stressed in comparison to patients treated under general balanced anesthesia with isoflurane-fentanyl.
Wydawca
Czasopismo
Rocznik
Tom
3
Numer
4
Strony
459-463
Opis fizyczny
Daty
wydano
2008-12-01
online
2008-10-22
Twórcy
  • Chair in Biochemistry, Faculty of Pharmacy, University of Tuzla, Tuzla, Bosnia and Herzegowina , zlata.mujagic@untz.ba
  • Clinic of Anaesthesiology and Reanimatology, University Clinical Center, Tuzla, Bosnia and Herzegowina
  • Clinic of Anaesthesiology, Reanimatology and Intensive Care, University Hospital Centre, School of Medicine, Zagreb, Croatia
  • Clinic of Anaesthesiology and Reanimatology, University Clinical Center, Tuzla, Bosnia and Herzegowina
Bibliografia
  • [1] Desborough J.P., Hall G.M., Endocrine response to surgery, In: Kaufman L., Anaesth. Rev., Vol. 10., Edinburgh: Churchill Livingstone, 1993
  • [2] Mathews C.K., Biochemistry, Addison Wesley Longman, 1999
  • [3] Desborough J.P., The stress response to trauma and surgery, Brit. J. Anaesth., 2000, 85, 109–117 http://dx.doi.org/10.1093/bja/85.1.109[Crossref]
  • [4] Marana E., Annetta M.G., Meo F., Parpaglioni R., Galeone M., Maussier M.L., Marana R., Sevoflurane improves the neuroendocrine stress response during laparoscopic pelvic surgery, Can. J. Anaesth., 2003, 50: 348–354
  • [5] Brockmann C., Raasch W., Bastian C., Endocrine stress parameters during TIVA with remifentanil or sufentanil, Anaesthesiol. Intensivmed. Nitfallmed. Schmerzther., 2000, 35: 685–691 http://dx.doi.org/10.1055/s-2000-8163[Crossref]
  • [6] Kocamanoglu I.S., Sahinoglu A.H., Tür A., Baris S., Karakaya D., The comparison of the effects of TIVA and inhalation anaesthesia on hemodynamic conditions, metabolic-endocrine response to trauma and muscle relaxant consumption, Turk. Anestez. Reanim., 2000, 28: 452–456
  • [7] Schricker T., Carli F., Schreiber M., Wachter U., Geisser W., Lattermann R., Georgieff M., Propofol/sufentanil anesthesia suppresses the metabolic and endocrine response during, not after, lower abdominal surgery, Anesth. Analg., 2000, 90: 450–455 http://dx.doi.org/10.1097/00000539-200002000-00039[Crossref]
  • [8] Winterhalter M., Adams H. A., Engels T., Rahe-Meyer N., Zuk J., Hagl C., Hecker H., Piepenbrock S., Endocrine stress response and myocardial outcome under balanced anesthesia with sevoflurane or TIVA with propofol in patients undergoing CABG, Intenzivmed. Notfallmed., 2007, 44: 166–177 http://dx.doi.org/10.1007/s00390-007-0771-0[Crossref]
  • [9] Ledowski T., Bein B., Hanss R., Paris A., Fudickar W., Scholz J., Tonner P.H., Neuroendocrine Stress Response and Heart Rate Variability: A Comparison of Total Intravenous Versus Balanced Anesthesia, Anesth. Analg., 2005,101:1700–1705 http://dx.doi.org/10.1213/01.ane.0000184041.32175.14[Crossref]
  • [10] Juckenhofel S., Feisel C., Schmitt H.J., Biedler A., TIVA with propofol-remifentanyl or balanced anesthesia with sevoflurane-fentanyl in laparoscopic operations: hemodynamics, awaking and adverse effects, Anaesthesist, 1999, 48: 807–812 http://dx.doi.org/10.1007/s001010050789[Crossref]
  • [11] Chung F., Mulier J.P., Scholz J., Breivik H., Araujo M., Hjelle K., Upadhyaya K., Haigh C., A comparison of anaesthesia using remifentanil combined with either isoflurane, enflurane or propofol in patients undergoing gynecological laparoscopy, varicose vein or arthroscopic surgery, Acta Anaesthesiol. Scand., 2000, 44: 790–798 http://dx.doi.org/10.1034/j.1399-6576.2000.440704.x[Crossref]
  • [12] Castillo V., Navas E., Naranjo R., Jimenez-Jimenez L., Changes in the concentrations of catecholamines and cortisol in balanced anesthesia and total intravenous anesthesia, Rev. Esp. Anesthesiol. Reanim., 1997, 44: 52–55
  • [13] Baldini G., Bagry H., Carli F., 44162 - Depth of anesthesia, the endocrine-metabolic stress response and the postoperative opoid requiments, Can. J. Anesth., 2007, 54: 44162
  • [14] Mujagić Z., Čičko E., Vegar-Brozović V., Prašo M., Serum levels of glucose and lactate in patients treated under total intravenous anesthesia with propofol-fentanyl and under balanced anesthesia with isoflurane-fentanyl, Bioch. Med., 2007, 17: 71–78
  • [15] Crozier T.A., Muller J.E., Quittkat D., Sydow M., Wuttke W., Kettler D., Total intravenous anesthesia with methohexitone-alfentanil or propofol-alfentanil: clinical aspects and hemodynamic, endocrine and metabolic effects. Anaesthesist 1994, 43: 594–604 http://dx.doi.org/10.1007/s001010050098[Crossref]
  • [16] Scarborough D.E., Cytokine modulation of pituitary hormone secretion, Ann. N.Y. Acad. Sci., 1990, 594: 169–187 http://dx.doi.org/10.1111/j.1749-6632.1990.tb40477.x[Crossref]
  • [17] Clevenger C.V., Russel D.H., Appasamy P.M., Prystowsky M.D., Regulation of interleukin2-driven T-Lymphocyte proliferation by prolactin, Proc. Natl. Acad. Sci. USA, 1990, 87: 6460–6464 http://dx.doi.org/10.1073/pnas.87.16.6460
  • [18] Ng A., Tan S.S.W., Lee H.S., Chew S.L., Effect of propofol infusion on the endocrine response to cardiac surgery., Anaesth. Intens. Care, 1995, 23: 543–547
  • [19] Carli F., Perioperative factors influencing surgical morbidity: what the anesthesiologist needs to know, Can. J. Anesth., 1999, 46: R70–74 http://dx.doi.org/10.1007/BF03013183[Crossref]
  • [20] Chrousos G.P., The role of stress and the hypothalamic-pituitary-adrenal axis in the pathogenesis of the metabolic syndrome: neuroendocrine and target tissue-related causes, Inter. J. Obes., 2000, 24: S50–55 http://dx.doi.org/10.1038/sj/ijo/0801278[Crossref]
  • [21] Collins T.C., Daley J., Henderson W.H., Khuri S.F., Risk factors for prolonged length of stay after major elective surgery, Ann. Surg., 1999, 230: 251–259 http://dx.doi.org/10.1097/00000658-199908000-00016[Crossref]
Typ dokumentu
Bibliografia
Identyfikatory
Identyfikator YADDA
bwmeta1.element.-psjd-doi-10_2478_s11536-008-0051-9
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