title: Stress indicators during general anesthesia with opioid analgesics in children.
abstract: OBJECTIVE
  To determine which of the applied opioid analgesics brings the most powerful blockade of the stress response with the fewest side effects in children.
  
  
  METHODS
  This was a prospective, observational clinical study. The study included 150 boys, aged 2-5 years, ASA I, who underwent herniectomy or orchidopexy in day case surgery. The introduction and maintenance of anesthesia was intravenous (propofol, rocuronium, and opioids); airway was maintained by laryngeal mask and ventilation by mixture of oxygen/air. Subjects were divided into 3 groups depending on the applied opioid analgesics (fentanyl, alfentanil, remifentanil).
  
  
  RESULTS
  The fentanyl group had the highest blood glucose values (AS = 5.14; SD = 0.47) and the highest increase in cortisone level at the moment of incision and at awakening (AS = 536.09; SD = 198.56). The lowest increase in cortisone was recorded in the remifentanil group. A significant decrease in leptin was registered at awakening in the fentanyl group and at the moment of incision in the remifentanil group (P= 0.939).
  
  
  CONCLUSIONS
  Remifentanil is the opioid analgesic with the highest suppressing effect on the stress response to surgical intervention in children.
authors.affiliation: University of Novi Sad, Serbia.
authors.forename: Biljana
authors.initials: B
authors.lastname: Draskovic
authors.forename: Danica
authors.initials: D
authors.lastname: Stanic
authors.forename: Anna
authors.initials: A
authors.lastname: Uram-Benka
authors.forename: Izabella
authors.initials: I
authors.lastname: Fabri
mesh_terms: D000701:Analgesics, Opioid / Q000494:pharmacology*; D000768:Anesthesia, General / Q000523:psychology*; D001786:Blood Glucose / Q000032:analysis; D003348:Cortisone / Q000097:blood; D005283:Fentanyl / Q000494:pharmacology; D006801:Humans; D010880:Piperidines / Q000494:pharmacology*; D011446:Prospective Studies; D000077208:Remifentanil; D013312:Stress, Physiological / Q000187:drug effects*
chemical_list: D000701:Analgesics, Opioid; D001786:Blood Glucose; D010880:Piperidines; D000077208:Remifentanil; D005283:Fentanyl; D003348:Cortisone