Hormonal and haemodynamic responses to upper abdominal surgery during isoflurane and balanced anaesthesia. 1984

S Gelman, and J E Rivas, and H Erdemir, and S Oparil, and J Proctor, and T MacKrell, and L Smith

The purpose of the study was to compare the protective role of different anaesthetic techniques against surgical stress. Sixty patients undergoing elective laparotomy were randomly divided into six groups of ten patients each: Group I was given 0.65 MAC nitrous oxide (66 per cent inspired) and 0.65 MAC isoflurane (0.75 per cent end-expired); Group II was given 0.65 MAC nitrous oxide and 1-1.2 MAC isoflurane (1.2-1.4 per cent end-expired); Group III was given the same anaesthetic management as patients in Group I but with the addition of fentanyl (2 micrograms X kg-1) before the skin incision and 1/8 of the initial dose every 15 minutes during surgery; Group IV was treated as patients in Group I with an additional infusion of lidocaine (30 micrograms X kg-1 X min-1); Groups V and VI were given 0.65 MAC of nitrous oxide and fentanyl, 7.5 and 15 micrograms X kg-1, respectively, before skin incision with 1/8 of the initial dose every 15 minutes during the operation; diazepam, 5 mg IV each hour of surgery, was given to prevent intraoperative awareness. Cortisol concentration was determined by radioimmunoassay method and catecholamines were measured by high performance liquid gas chromatography in blood samples taken at different stages perioperatively. All patients had satisfactory haemodynamic courses of anaesthesia. Statistically significant increases in both epinephrine and norepinephrine concentrations were observed during the immediate postoperative period in Group I patients only. Haemodynamic stability was maintained despite a two- to three-fold increase in cortisol which occurred during the operation and immediate postoperative period.(ABSTRACT TRUNCATED AT 250 WORDS)

UI MeSH Term Description Entries
D007530 Isoflurane A stable, non-explosive inhalation anesthetic, relatively free from significant side effects.
D008297 Male Males
D008738 Methyl Ethers A group of compounds that contain the general formula R-OCH3. Ethers, Methyl
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009609 Nitrous Oxide Nitrogen oxide (N2O). A colorless, odorless gas that is used as an anesthetic and analgesic. High concentrations cause a narcotic effect and may replace oxygen, causing death by asphyxia. It is also used as a food aerosol in the preparation of whipping cream. Laughing Gas,Nitrogen Protoxide,Gas, Laughing,Oxide, Nitrous
D009638 Norepinephrine Precursor of epinephrine that is secreted by the ADRENAL MEDULLA and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers, and of the diffuse projection system in the brain that arises from the LOCUS CERULEUS. It is also found in plants and is used pharmacologically as a sympathomimetic. Levarterenol,Levonorepinephrine,Noradrenaline,Arterenol,Levonor,Levophed,Levophed Bitartrate,Noradrenaline Bitartrate,Noradrénaline tartrate renaudin,Norepinephrin d-Tartrate (1:1),Norepinephrine Bitartrate,Norepinephrine Hydrochloride,Norepinephrine Hydrochloride, (+)-Isomer,Norepinephrine Hydrochloride, (+,-)-Isomer,Norepinephrine d-Tartrate (1:1),Norepinephrine l-Tartrate (1:1),Norepinephrine l-Tartrate (1:1), (+,-)-Isomer,Norepinephrine l-Tartrate (1:1), Monohydrate,Norepinephrine l-Tartrate (1:1), Monohydrate, (+)-Isomer,Norepinephrine l-Tartrate (1:2),Norepinephrine l-Tartrate, (+)-Isomer,Norepinephrine, (+)-Isomer,Norepinephrine, (+,-)-Isomer
D002763 Cholecystectomy Surgical removal of the GALLBLADDER. Cholecystectomies
D004305 Dose-Response Relationship, Drug The relationship between the dose of an administered drug and the response of the organism to the drug. Dose Response Relationship, Drug,Dose-Response Relationships, Drug,Drug Dose-Response Relationship,Drug Dose-Response Relationships,Relationship, Drug Dose-Response,Relationships, Drug Dose-Response
D004837 Epinephrine The active sympathomimetic hormone from the ADRENAL MEDULLA. It stimulates both the alpha- and beta- adrenergic systems, causes systemic VASOCONSTRICTION and gastrointestinal relaxation, stimulates the HEART, and dilates BRONCHI and cerebral vessels. It is used in ASTHMA and CARDIAC FAILURE and to delay absorption of local ANESTHETICS. Adrenaline,4-(1-Hydroxy-2-(methylamino)ethyl)-1,2-benzenediol,Adrenaline Acid Tartrate,Adrenaline Bitartrate,Adrenaline Hydrochloride,Epifrin,Epinephrine Acetate,Epinephrine Bitartrate,Epinephrine Hydrochloride,Epinephrine Hydrogen Tartrate,Epitrate,Lyophrin,Medihaler-Epi,Acetate, Epinephrine
D005260 Female Females

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