[Catabolic stress response during and after abdominal surgery. Comparison between two anaesthesia procedures].
BACKGROUND
The purpose of the study was to investigate the effect of modified neuroleptanesthesia (NLA) with fentanyl/midazolam on the catabolic responses during and after abdominal surgery.


METHODS
A total of 13 patients undergoing cystoprostatectomy received either modified NLA ( n=7) or inhaled anesthesia with isoflurane (ISO, n=6). Glucose and urea production rates were assessed before, during and 1 day after the operation. Plasma concentrations of glucose, urea, lactate, insulin, glucagon and cortisol were also determined.


RESULTS
In contrast to isoflurane anesthesia, modified NLA prevented an increase in plasma glucose concentration and glucose production during ( P<0.05), but not after surgery. There were no differences in perioperative urea production rates or plasma concentrations of urea, insulin, glucagon and lactate between the two groups. Modified NLA suppressed the intraoperative increase in plasma cortisol concentration as observed in the ISO group ( P<0.05).


CONCLUSIONS
Modified NLA inhibits the increase in plasma glucose concentration and glucose production as seen during isoflurane anesthesia. However, NLA does not influence the catabolic response on the first postoperative day.
Lattermann
R
R
Klinik für Anästhesiologie, Klinikum der Universität Regensburg.
Wachter
U
U
Georgieff
M
M
Goertz
A
A
Schricker
T
T
D000005:Abdomen / Q000601:surgery*; D000368:Aged; D000769:Anesthesia, Inhalation; D000771:Anesthesia, Intravenous; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D001786:Blood Glucose / Q000378:metabolism; D005283:Fentanyl; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007530:Isoflurane; D008297:Male; D008874:Midazolam; D008875:Middle Aged; D011184:Postoperative Period; D011468:Prostatectomy; D013312:Stress, Physiological / Q000503:physiopathology*; D014508:Urea / Q000097:blood
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D001786:Blood Glucose; D014508:Urea; D007530:Isoflurane; D008874:Midazolam; D005283:Fentanyl; D006854:Hydrocortisone