Effect of different doses of remifentanil on stress response during laparoscopic cholecystectomy.

Autor:	Sessa F; Department of Anesthesiology and Intensive Care Medicine, Fondazione Policlinico Universitario 'A. Gemelli', IRCCS, Rome, Italy., Levantesi L; Department of Anesthesiology and Intensive Care Medicine, Fondazione Policlinico Universitario 'A. Gemelli', IRCCS, Rome, Italy., Congedo E; Department of Anesthesiology and Intensive Care Medicine, Perrino Hospital, Brindisi, Italy., Di Nardo F; Public Health Institute, Section of Hygiene, Fondazione Policlinico Universitario 'A. Gemelli', IRCCS, Rome, Italy., Oggiano M; Department of Anesthesiology and Intensive Care Medicine, Fondazione Policlinico Universitario 'A. Gemelli', IRCCS, Rome, Italy., Canistro G; Department of Anesthesiology and Intensive Care Medicine, Fondazione Policlinico Universitario 'A. Gemelli', IRCCS, Rome, Italy., Sicuranza R; Department of Anesthesiology and Intensive Care Medicine, Fondazione Policlinico Universitario 'A. Gemelli', IRCCS, Rome, Italy., Nicosia L; Department of Anesthesiology and Intensive Care Medicine, Fondazione Policlinico Universitario 'A. Gemelli', IRCCS, Rome, Italy., De Cosmo G
Jazyk:	angličtina
Zdroj:	Journal of opioid management [J Opioid Manag] 2019 Jan/Feb; Vol. 15 (1), pp. 43-49.
DOI:	10.5055/jom.2019.0485
Abstrakt:	Objectives: An adequate perioperative analgesia reduces neuroendocrine stress response and postoperative complica-tions. Opioids are the most effective parenteral drugs to control pain and stress response. Design: This is a prospective randomized double-blinded controlled study. Setting: Institutional tertiary level. Patients, Participants: Fifty patients underwent general anesthesia with desflurane for laparoscopic cholecystectomy. Main Outcome Measures: To compare two different doses of remifentanil (0.15 mcg/kg/min or 0.3 mcg/kg/min) in reducing markers of stress. Perioperative stress was assessed through the dosage of adrenocorticotropic hormone (ACTH), cortisol, growth hormone (GH), and prolactin (PRL). Three venous blood samples were collected from patients: before transferring the patient to the operating room (Time 0), at the trocar insertion (Time 1), and 1 hour after the end of the surgery (Time 2). Results: Hemodynamic parameters showed no differences between the two groups. The authors observed an increase of GH and PRL in both groups at trocar insertion (Time 1) ( p = 0.473 and 0.754, respectively). ACTH and cortisol showed a decrease at Time 1 and an increase after surgery (p = 0.586). The modification of stress parameters levels showed no significant differences between the two groups. Conclusions: The results of our study showed that a lower dose of remifentanil is equally effective in controlling stress hormones during laparoscopic cholecystectomy.
Databáze:	MEDLINE
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