EFFECT OF REMIFENTANil ON STRESS RESPONSE DURING LAPAROSCOPIC ONCOLOGIC SURGERY IN RELATION TO MORPHINE
Basem Henry Habib;
Abstract
It is known that tissue trauma. sun>.en• and anesthesia associated with the variety of metabolic and harmon a I changesLich as the activation of the pituitary adrenal svstem and alteration of carboll\ drate metabolism. These changes could be regarded "as the nonspecific response ofthe body to stress. increased c tabolism or impaired caloric intake. although the e:-;act mechanism causing such endocrine and metabolic abnormalities have not yet been clarified.
The aim of this studv is to shed li!!ht on the effect of different narcotics (morphine. low dose remif ntanil. high lose remifentanil) on metabolic and hormonal changes.
It was conducted on 60 patients ASA class I and II scheduled for elective laparoscoic oncologic surgeries.
These were divided into 3 groups:
1- Morphine group
2- Low dose remifentanil group
3- high dose remifentanil group each group included 20 patients.
Blood samples were obtained in the morning of the operation, before surgery. 30 minutes after induction of anesthesia. 2 hours after induction of anesthesia. and 24 hours after induction of anesthesia for estimation of growth hormone. cortisol. insuline and glucose levels in the patient's serum.
In the present study. it was found that there was an increase in cortisol, growth hormone, glucose level and decrease in insuline level after induction of anesthesia than the preoperative levels .
There was no statistically significant difference between the 3 groups as regard growth honnon, glucose and insuline levels but the increase in cortisol level was less marked in remifentanil groups (group II and Ill) than that in morphine group and the difference was statistically significant.
In conclusion, the present stud) shm\ed that the stress response in remifentanil groups \Vas less marked than morphine group so it is advisable to use remifentanil during anesthesia to provide suitable environment for tissue healing and repair.
It is preferable to use Jo,, dose remifentanil than high dose remifentanil as the haemodynamic changes '' ith the first was less marked than high dose remifentanil especially there \\as nP statisticall: significant difference between the effects on metabolic and hormonal changes.
The aim of this studv is to shed li!!ht on the effect of different narcotics (morphine. low dose remif ntanil. high lose remifentanil) on metabolic and hormonal changes.
It was conducted on 60 patients ASA class I and II scheduled for elective laparoscoic oncologic surgeries.
These were divided into 3 groups:
1- Morphine group
2- Low dose remifentanil group
3- high dose remifentanil group each group included 20 patients.
Blood samples were obtained in the morning of the operation, before surgery. 30 minutes after induction of anesthesia. 2 hours after induction of anesthesia. and 24 hours after induction of anesthesia for estimation of growth hormone. cortisol. insuline and glucose levels in the patient's serum.
In the present study. it was found that there was an increase in cortisol, growth hormone, glucose level and decrease in insuline level after induction of anesthesia than the preoperative levels .
There was no statistically significant difference between the 3 groups as regard growth honnon, glucose and insuline levels but the increase in cortisol level was less marked in remifentanil groups (group II and Ill) than that in morphine group and the difference was statistically significant.
In conclusion, the present stud) shm\ed that the stress response in remifentanil groups \Vas less marked than morphine group so it is advisable to use remifentanil during anesthesia to provide suitable environment for tissue healing and repair.
It is preferable to use Jo,, dose remifentanil than high dose remifentanil as the haemodynamic changes '' ith the first was less marked than high dose remifentanil especially there \\as nP statisticall: significant difference between the effects on metabolic and hormonal changes.
Other data
| Title | EFFECT OF REMIFENTANil ON STRESS RESPONSE DURING LAPAROSCOPIC ONCOLOGIC SURGERY IN RELATION TO MORPHINE | Other Titles | تأثير عقار الريميفينتانيل على الإستجابة للإنفعالات أثناء عمليات جراحة الأورام باستخدام المنظار مقارنة بالمورفين | Authors | Basem Henry Habib | Issue Date | 2005 |
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