E-ISSN: 2667-6370
The Effects of Different Anaesthetic Techniques on Surgical Stress Response During Inguinal Hernia Operations
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Original Article
VOLUME: 43 ISSUE: 2
P: 91-99
April 2015

The Effects of Different Anaesthetic Techniques on Surgical Stress Response During Inguinal Hernia Operations

Turk J Anaesthesiol Reanim 2015;43(2):91-99
DOI: 10.5152/TJAR.2014.49092
Derya Acar 1
Ezgi Karakaş Erkılıç 1
Tülin Gümüş 1
Duygu Şahin 2
Aylin Sepici Dinçel 2
Orhan Kanbak 1
1. T.C. Sağlık Bakanlığı, Atatürk Eğitim ve Araştırma Hastanesi, Anestezi ve Reanimasyon Kliniği, Ankara, Türkiye
2. Gazi Üniversitesi Tıp Fakültesi, Tıbbi Biyokimya Anabilim Dalı, Ankara, Türkiye
No information available.
No information available
Received Date: 15.01.2014
Accepted Date: 19.06.2014
Publish Date: 05.02.2015
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ABSTRACT

Objective:

The aim of this study is to compare the effects of 3 different kinds of anaesthesia on stress response induced by surgery.

Methods:

Sixty patients aged between 25-70 American Society of Anesthesiologists (ASA) I-II group to undergo inguinal herniography were included in this study. Patients were randomly divided into 3 groups of 20. Group 1 received general anaesthesia with sevoflurane/air/remifentanil, patients in Group 2 received total intravenous anaesthesia (TIVA) with propofol/air/remifentanil and Group 3 received spinal anaesthesia induced by hyperbaric bupivacaine, adjoined by remifentanil sedation. Mean arterial pressure (MAP), heart rate and SpO2 values were recorded preoperatively, intraoperatively and postoperatively at certain periods. Cortisol, leptin and glucose levels were preoperatively detected. Intervals were as; 15 minutes prior to the induction of anesthesia, at intraoperative first hour and at the postoperative third and twentyforth hours.

Results:

MAP and heart rate values were similar in the inhalational anaesthesia and TIVA groups but relatively higher in the spinal anaesthesia group. Blood glucose levels were elevated, insulin levels were decreased in all groups, at the intraoperative first hour. Biphasic variation in blood leptin levels was observed in all groups, as the levels were lower than the preoperative control values at the intraoperative first and postoperative third hours and significantly higher at the postoperative twenty-forth hour. There was a significant decrease in cortisol level percentage change in the TIVA group at the intraoperative 1st hour, increasing in the other groups.

Conclusion:

We concluded that TIVA supresses the stress response induced by surgery better by lowering cortisol levels, leading to a lower increase in blood glucose levels and a lower decrease in blood insulin levels when compared to others. Furthermore, leptin levels were increased at the postoperative twenty-forth hour. The lower increase at the postoperative twenty-forth hour in the TIVA group can be correlated with the anaesthetic agent.

Keywords: Stress response of surgery, leptin, TIVA, inhalation anaesthesia, spinal anaesthesia

References

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