title: The effect of anesthesia method on serum level of pro-brain natriuretic Peptide in patients undergoing orthopedic surgery.
abstract: BACKGROUND
  Surgical stress response is among the most severe stress tolerated by the patient, which needs suppression by anesthesia.
  
  
  OBJECTIVE
  We assessed the effect of three methods of anesthesia on postoperative levels of pro-brain natriuretic peptide (pro-BNP) to determine the most effective one in preventing surgical stress response.
  
  
  METHODS
  In a randomized clinical trial, 120 patients who were 18 to 65 years old and met inclusion and exclusion criteria were selected and randomly allocated to three groups of 40:Group A, general anesthesia plus epidural catheter; Group B, general anesthesia and intravenous patient-controlled analgesia; and Group C, spinal anesthesia plus intravenous patient-controlled analgesia.
  
  
  RESULTS
  There was no difference between three groups for basic characteristics and variables and baseline pro-BNP levels; however, postoperative pro-BNP levels in Groups A, B, and C were respectively63.8 ± 10.1, 83.2 ± 12.3, and 51.5 ± 8.5 ng/L (ANOVA, P = 0.01).
  
  
  CONCLUSIONS
  The results of the current study suggested that spinal anesthesia plus intravenous patient-controlled analgesia have the most favorable cardiac effects regarding postoperative levels of pro-BNP.
authors.affiliation: Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Mirkheshti
authors.affiliation: Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Masoume
authors.initials: M
authors.lastname: Heidari Farzan
authors.affiliation: Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Yashar
authors.initials: Y
authors.lastname: Nasiri
authors.affiliation: Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Kamran
authors.initials: K
authors.lastname: Mottaghi
authors.affiliation: Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Dabbagh
keywords: Analgesia; Brain Natriuretic Peptide; Orthopedics