[Comparison of total intravenous anesthesia and inhalation anesthesia regarding hormonal responses during lung lobectomy].
BACKGROUND
Anesthetic techniques can modulate surgical stress responses. We studied the response of plasma epinephrine, norepinephrine, dopamine, adrenocorticotrophic hormone (ACTH), and serum cortisol during lung lobectomy under sevoflurane, propofol and fentanyl anesthesia.


METHODS
Fifty patients with lung cancer were of ASA physical status 1 or 2 and aged 50-75 yr. Blood samples were drawn before anesthetic induction, 5 min after tracheal extubation, and 24 h as well as 72 h after operation.


RESULTS
Five min after tracheal extubation, plasma levels of epinephrine, norepinephrine and dopamine were significantly lower in the group that had received propofol - fentanyl anesthesia (P-F group) compared with the group that had received sevoflurane-fentanyl anesthesia (S-F group). In the P-F group, plasma levels of norepinephrine and dopamine 5 min after tracheal extubation were the same as the pre-induction levels. The increase in ACTH levels was significantly less in the P-F group in comparison with the group S-F.


CONCLUSIONS
Propofol-fentanyl anaesthesia prevents the increase in catecholamines and reduces the ACTH response during lung lobectomy.
Satani
Makoto
M
Department of Anesthesia, Osaka City General Hospital, Osaka 534-0021.
Hamada
Taku
T
Nakada
Kazuo
K
Umemoto
Yasuhiro
Y
Fujii
Takashi
T
Takaki
Osamu
O
D000324:Adrenocorticotropic Hormone / Q000097:blood; D000368:Aged; D000769:Anesthesia, Inhalation; D000771:Anesthesia, Intravenous; D002395:Catecholamines / Q000097:blood*; D004298:Dopamine / Q000097:blood*; D005260:Female; D005283:Fentanyl; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D008738:Methyl Ethers; D008875:Middle Aged; D011013:Pneumonectomy; D015742:Propofol; D000077149:Sevoflurane
D002395:Catecholamines; D008738:Methyl Ethers; D000077149:Sevoflurane; D000324:Adrenocorticotropic Hormone; D005283:Fentanyl; D004298:Dopamine; D006854:Hydrocortisone; D015742:Propofol