Comparison of hemodynamic and neuroendocrine changes during total intravenous anesthesia and inhalation anesthesia
Küçük Resim Yok
Tarih
2001
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Elsevier
Erişim Hakkı
CC0 1.0 Universal
info:eu-repo/semantics/openAccess
info:eu-repo/semantics/openAccess
Özet
Background: Various aspects of anesthesia and surgery cause stress-induced endocrine and metabolic changes in organisms due to stimulation of the sympathoadrenergic system. Intravenous and inhalation anesthetic agents alter endocrine and metabolic responses to surgical stimuli. Objective: The objective of this study was to compare the effects of 2 anesthesia methods on patient response to surgical stress. Three components of general anesthesia were involved: hypnosis, analgesia, and muscle relaxation. Methods: Patients were randomly assigned to 1 of 3 groups: Group I received total intravenous anesthesia (TIVA) using propofol and alfentanil. Group II received inhalation anesthesia and was divided into 2 subgroups: group IIA received isoflurane, and group IIB received sevoflurane. Patients from all 3 groups underwent assessment of hemodynamic variables (heart rate, systolic blood pressure [SBP], and diastolic blood pressure [DBP]) and endocrinologic variables (plasma levels of blood glucose, C peptide, insulin, catecholamines [epinephrine, norepinephrine], and cortisol). Results: Sixty patients were enrolled in the study and assigned to 1 of the 3 groups (20 per group). Heart rate decreased significantly (P < 0.05) after induction and remained lower than the preinduction value throughout surgery in the TIVA group. Significant increases in heart rate occurred in both inhalation anesthesia groups: after intubation (P < 0.01) and after extubation (P < 0.05) in the isoflurane group; after induction, intubation, and extubation (P < 0.05) in the sevoflurane group. SBP decreased significantly in the TIVA group (P < 0.01 after induction and P < 0.05 thereafter); significant increases (P < 0.05) were seen after intubation and after extubation in both inhalation anesthesia groups. DBP decreased (P < 0.05) after intubation in the TIVA group and increased in the isoflurane group (P < 0.01 after intubation and incision, P < 0.05 after extubation). At the first intraoperative hour, significant increases compared with preinduction values (P < 0.05) were observed in C peptide and insulin levels in the TIVA group, epinephrine in the isoflurane group, and blood glucose and norepinephrine in both inhalation anesthesia groups. Significant decreases (P < 0.05) were found in C peptide and insulin levels in the 2 inhalation anesthesia groups. Measurements taken at the second postoperative hour and compared with preinduction values revealed significant increases (P < 0.05) in C peptide in all groups, norepinephrine in the TIVA group, and insulin and cortisol in the 2 inhalation anesthesia groups. Conclusions: Based on our results, we concluded that hemodynamic and neuroendocrine responses to surgical stress are better controlled with TIVA compared with inhalation anesthesia.
Açıklama
Anahtar Kelimeler
total intravenous anesthesia, isoflurane, sevoflurane, cortisol, epinephrine
Kaynak
Current therapeutic research
WoS Q Değeri
Scopus Q Değeri
Q3
Cilt
62
Sayı
2
Künye
Özkan, S., Cingözbay, B. Y., Usyılmaz, S., Çankır, Z., Cebeci, B. S. ve Gökben, M. (2001). Comparison of hemodynamic and neuroendocrine changes during total intravenous anesthesia and inhalation anesthesia. Current therapeutic research, Elsevier. 62(2), s. 142-152.
