AI Summary & Key Takeaways
AI InsightPlasma cortisol , ACTH, prolactin, insulin, glucose and leptin concentration were determined ,one hour post-incision and 24th hours with RIA or IRMA methods as appropriate.Results: Hemodynamic response to intubation and surgical incision was depressed at alfentanil and remifentanil groups (p
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Abstract
Aim: This study compared the hemodynamic, metabolic and endocrine including leptin responses to surgery with total intravenous anesthesia (TIVA) with propofol-alfentanil or propofol-remifentanil and sevoflurane anesthesia.Materials ve Methods: Fortyfive ASA I-II, patients scheduled to undergo abdominal surgery were randomly divided into three groups (N=15). General anaesthesia induction and neuromuscular paralysis were performed in all patients with 1,5 mg kg-1 propofol and 0.1 mg kg-1 vecuronium respectively. In Addition group I patients were given 1 µg kg-1 fentanyl, group II patients were given 40 µg kg-1 alfentanil and group III patients were given 1 µg kg-1 remifentanil. Maintenance anaesthesia was performed in group I with 1.5-3 % sevoflurane and 50 % N2O/O2 in group II with 100 µg kg-1 min-1 propofol and 2 µg kg-1 min-1 alfentanil and after the first hour 1 µg kg-1 min-1 alfentanil infusion. Third group was administered 100 µg kg-1 propofol and 0.25 µg kg-1 min-1 remifentanil infusion. Hemodynamic changes were recorded. Plasma cortisol , ACTH, prolactin, insulin, glucose and leptin concentration were determined ,one hour post-incision and 24th hours with RIA or IRMA methods as appropriate.Results: Hemodynamic response to intubation and surgical incision was depressed at alfentanil and remifentanil groups (p
Özet
Amaç: Bu çalışmada, propofol-alfentanil ve propofol-remifentanil kullanılan total intravenöz anestezi (TİVA) ile sevofluran anestezisinin cerrahi strese karşı hemodinamik, metabolik ve leptin dahil endokrin yanıtları karşılaştırıldı.Gereç ve Yöntem: ASA I-II grubunda, batın operasyonu planlanan 45 hasta rasgele üç gruba ayrıldı. Genel anestezi indüksiyonu tüm gruplarda 1.5 mg kg-1 propofol ve nöromuskuler paralizi 0.1 mg kg-1 veküronyum ile yapıldı ve ek olarak Grup I'e 1 µg kg-1 fentanil, Grup II'e 40 µg kg-1 alfentanil, Grup III'e 1 µg kg-1 remifentanil kullanıldı. Anestezi idamesinde; I. grupta; % 1.5-3 sevofluran + % 50 N2O/O2, II. grupta 100 µg kg-1 dk-1 propofol + 2 µg kg-1 dk-1 alfentanil, 1. saatten sonra 1 µg kg-1 dk-1 alfentanil, III. grupta 100 µg kg-1 dk-1 propofol ve 0.25 µg kg-1 dk-1 remifentanil infüzyonu yapıldı. Hemodinamik değişiklikleri kaydedildi. Plazma kortizol, ACTH, prolaktin, insülin, glukoz ve leptin düzeylerinin ölçümleri, indüksiyon öncesi, indüksiyondan 60. dk. sonra ve postoperatif 24. saatte RİA veya İRMA yöntemleri ile yapıldı.Bulgular: Entübasyon ve cerrahi insizyona hemodinamik yanıt alfentanil ve remifentanil gruplarında baskılandı (p