Somatostatin and total intravenous anaesthesia. Assessment of analgesic requirements during surgery and the effects on liver enzymes.
We have studied the analgesic effects of somatostatin during surgery and its influence on the plasma glucose levels and the liver enzyme profile in 40 ASA 1 or 2 patients undergoing surgery for carcinoma of the gastrointestinal tract. Each patient received either somatostatin bolus 3.5 micrograms.kg-1 intravenously plus an infusion of somatostatin 3.5 micrograms.kg-1.h-1, or sodium chloride 0.9% as a placebo in a double-blind manner. Anaesthesia was induced with propofol 1 mg.kg-1 followed by a continuous infusion of propofol in a stepwise declining regimen. Vecuronium was used for muscular relaxation. Fentanyl 100 micrograms was administered intravenously in bolus doses for analgesia during surgery as required. Blood samples were taken at 10 min pre-induction, 5 min postintubation, 5, 30, 60, 120 min postincision and 30 min post-recovery for plasma glucose levels. Blood samples were also taken at 10 min pre-induction, 120 min postincision and 24 h postoperatively for liver enzymes. The total requirement for fentanyl in the control group was significantly higher (p < 0.001) than in the group that received somatostatin. Eight out of 20 patients in the study group required no additional analgesia intra-operatively. The changes in blood glucose values followed the same pattern in both groups. There was a tendency for liver enzymes to increase in both groups. Although this increase was less in the study group, this change was not statistically significant.
Kanakoudis
F S
FS
Department of Anaesthesia, Anticancer Hospital Theagenio, Thessaloniki, Greece.
Konstantinidou
A S
AS
Petrou
A
A
Taliouridou
E I
EI
Papadopoulou-Bouti
A L
AL
Michaloudis
D G
DG
D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000187:drug effects; D000771:Anesthesia, Intravenous; D001219:Aspartate Aminotransferases / Q000187:drug effects; D001786:Blood Glucose / Q000187:drug effects; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D005283:Fentanyl; D005770:Gastrointestinal Neoplasms / Q000601:surgery*; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000187:drug effects; D008099:Liver / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015742:Propofol; D013004:Somatostatin / Q000494:pharmacology*
D001786:Blood Glucose; D013004:Somatostatin; D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D005283:Fentanyl; D015742:Propofol