The differential impact of volatile and intravenous anaesthetics on stress response in the swine.
OBJECTIVE
To compare the effects of various anaesthetics on stress response in the presence and absence of surgical stimulation.


METHODS
Twenty-nine pigs scheduled to undergo surgical central vein catheter placement were randomly allocated to receive only sedation with ketamine-midazolam (group SHAM, n=5) or general anaesthesia with either propofol 8 mg/kg/h (group PROP, n=8), sevoflurane 1.0 MAC (group SEVO, n=8) or desflurane 1.0 MAC (group DESF, n=8). Following surgery, anaesthesia was maintained for a total period of 4 hours. Thyroid hormones, noradrenaline, cortisol, corticotrophin (ACTH), beta-endorphin, interleukin-1beta and -6 and tumor necrosis factor-alpha were determined by appropriate methodology after premedication (t0), after surgical procedure (t1) and at the end of 4h (t2).


RESULTS
At t1 ACTH and beta-endorphin increased in all groups, thyroxin in groups SEVO, DESF and PROP, noradrenaline in group SEVO and cortisol in the SHAM and PROP groups. At t2 cortisol and ACTH levels were lower in the PROP compared to SEVO group. Serum cytokines were not significantly altered in either group.


CONCLUSIONS
The choice of the general anaesthetic did not affect thyroid hormones levels in either the presence or absence of surgical stimulus. In the presence of surgical stimulation, sevoflurane resulted in higher noradrenaline levels and in higher activity of the ACTH-cortisol axis compared to propofol.
Kostopanagiotou
Georgia
G
2nd Department of Anaesthesiology, School of Medicine, University of Athens, Attikon Hospital, Athens, Greece. k_kalimeris@hotmail.com
Kalimeris
Konstantinos
K
Christodoulaki
Kalliopi
K
Nastos
Constantinos
C
Papoutsidakis
Nikolaos
N
Dima
Cleanthi
C
Chrelias
Charalampos
C
Pandazi
Ageliki
A
Mourouzis
Iordanis
I
Pantos
Constantinos
C
D000280:Administration, Inhalation; D000324:Adrenocorticotropic Hormone / Q000097:blood; D018685:Anesthetics, Inhalation / Q000008:administration & dosage* / Q000494:pharmacology*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage* / Q000494:pharmacology*; D000818:Animals; D015415:Biomarkers / Q000097:blood; D002405:Catheterization, Central Venous; D000077335:Desflurane; D005260:Female; D006854:Hydrocortisone / Q000031:analogs & derivatives / Q000097:blood; D007262:Infusions, Intravenous; D007530:Isoflurane / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000494:pharmacology; D008738:Methyl Ethers / Q000008:administration & dosage / Q000494:pharmacology; D009638:Norepinephrine / Q000097:blood; D015742:Propofol / Q000008:administration & dosage / Q000494:pharmacology; D011897:Random Allocation; D000077149:Sevoflurane; D013223:Statistics as Topic; D013312:Stress, Physiological / Q000187:drug effects*; D013514:Surgical Procedures, Operative; D034421:Sus scrofa; D013963:Thyroid Hormones / Q000097:blood; D001615:beta-Endorphin / Q000097:blood
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D015415:Biomarkers; D008738:Methyl Ethers; D013963:Thyroid Hormones; D000077149:Sevoflurane; D001615:beta-Endorphin; D000324:Adrenocorticotropic Hormone; D000077335:Desflurane; D007530:Isoflurane; D006854:Hydrocortisone; D009638:Norepinephrine; D015742:Propofol