[Protective efficacy of 3 anesthetic methods with reference to surgical stress in children]

Cah Anesthesiol. 1996;44(4):297-302.
[Article in French]

Abstract

Hormonal-metabolic stress responses have beyond doubt an effect on morbidity/mortality related to surgery. The present study med to determine which anaesthetic technique could afford the best protection in children, through analysis of the perioperative cortisol, prolactin and beta-endorphin plasma levels. Thirty-six young patients 3-10 years old, ASA I-II, scheduled for hypospadias or vesicoureteral reflux surgery of a duration > 60 min, were randomized into three groups (n = 12). Children of group I were given initially propofol and fentanyl then isoflurane 1%; group 2 received TIVA with propofol and fentanyl, group 3 received initially propofol then an epidural lumbar block with bupivacaine 0.25% (single shot) and continuous propofol i.v. infusion. Cortisol, prolactin and beta-endorphin levels increased significantly in group 1 only. No significant differences were observed between group 2 and 3. Early postoperative analgesia was better in group 3. These data suggest that TIVA and particularly epidural block could afford a better protection against the surgical stress in children submitted to subumbilical operations.

Publication types

  • Clinical Trial
  • Comparative Study
  • English Abstract
  • Randomized Controlled Trial

MeSH terms

  • Anesthesia, General / methods*
  • Child
  • Child, Preschool
  • Humans
  • Hydrocortisone / blood
  • Prolactin / blood
  • Stress, Physiological / etiology
  • Stress, Physiological / prevention & control*
  • Surgical Procedures, Operative / adverse effects*
  • beta-Endorphin / blood

Substances

  • beta-Endorphin
  • Prolactin
  • Hydrocortisone