Depth of anesthesia with desflurane does not influence the endocrine‐metabolic response to pelvic surgery

Baldini, Gabriele; Bagry, Hema; Carli, Franco

doi:10.1111/j.1399-6576.2007.01470.x

Cited by 27 publications

(22 citation statements)

References 19 publications

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“…So it can be concluded that hyperglycemia during inhalation anesthesia may be due to surgical pain and stimulation of sympathic system. The results of Baldini et al [17] study confirm this concept as this study showed that the depth of anesthesia with desflurane has no effect on the blood glucose during the surgery and even deep anesthesia with desflurane doesn't prevent hyperglycemia. In fact the reason of hyperglycemia during surgery may be surgical pain and metabolic response to surgical stress that even deep anesthesia cannot block these responses, but with enough analgesia we can maintain blood glucose in normal limits and prevent hyperglycemia and its complications during perioperative period.…”

Section: Discussionsupporting

confidence: 55%

The Effects of Propofol and Isoflurane on Blood Glucose during Abdominal Hysterectomy in Diabetic Patients

et al. 2014

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BackgroundAcute hyperglycemia in the perioperative period is associated with significantly increased complications. In few human studies the effects of propofol and inhalational anesthetic on the glucose metabolism were compared. In this study we evaluated the effect of propofol and isoflurane on blood glucose during abdominal hysterectomy in diabetic patients.MethodsAfter approval by the Ethical Committee and written informed consent, thirty 35 to 65 years old diabetic women underwent for elective abdominal hysterectomy under general anesthesia were studied in this randomized single blind clinical trial study. The plasma glucose was maintained at 100 to 180 mg/dL during the operation. Anesthesia protocol was similar in two groups except maintenance of anesthesia that was with infusion of propofol in the propofol group and with isoflurane in the isoflurane group. Blood glucose level and the rate of insulin intake during surgery compared between two groups.ResultsMean blood glucose before induction of anesthesia did not have significant difference between two groups, but 60 and 90 minutes after starting the operation blood glucose in the propofol group was significantly lower than isoflurane group. Also with using Repeated Measure test, two groups was significantly different according to blood glucose (P=0.045). Mean of administration of insulin during the surgery did not have significant difference between two groups by using repeated measure test and P=0.271. Also mean of bispectral index in different times during the surgery between two groups didn't have significant difference (P=0.35 repeated measure test).ConclusionBlood glucose increased during maintenance of anesthesia with isoflurane compared to propofol during the surgery.

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Section: Discussionsupporting

confidence: 55%

The Effects of Propofol and Isoflurane on Blood Glucose during Abdominal Hysterectomy in Diabetic Patients

et al. 2014

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“…A high or low isoflurane concentration has not been shown to have any effect on magnitude of blood pressure increase after stimuli in humans [47]. In another study on people, different concentrations of desflurane did not influence the endocrine response to surgery [52]. In the present study the end-tidal isoflurane concentration did not differ significantly between phases or the groups’ corresponding phases.…”

Section: Discussioncontrasting

confidence: 46%

Blood pressure and heart rate during ovariohysterectomy in pyometra and control dogs: a preliminary investigation

Höglund

Lövebrant²,

Olsson

et al. 2016

Acta Vet Scand

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BackgroundSurgery causes a stress response, a physiologic response to trauma. The intraoperative surgical stress response in dogs diagnosed with pyometra has not previously been described. The aim of this study was to investigate the intraoperative surgical stress response, assessed by blood pressure and heart rate measurements, in dogs diagnosed with pyometra and healthy controls. All dogs were premedicated with acepromazine and methadone, anaesthesia was induced with propofol and maintained with isoflurane, where after the dogs were subjected to ovariohysterectomy.ResultsEight dogs diagnosed with pyometra and eight healthy controls were used. Systolic blood pressure and heart rate were measured to assess the surgical stress response. Additionally propofol dosage at induction of anaesthesia and the end-tidal isoflurane concentration were investigated. The surgery was split into four phases. Phase 0 was the period 10 min before the skin incision, phase 1 was skin incision and opening of abdomen, phase 2 was manipulation of uterine horns, lifting of the ovary with stretching of the mesovarium, ligation and transection of mesovarium and phase 3 was ligation and transection of cervix, removal of organs and closing of the abdomen. Dosage of propofol at induction of anaesthesia was 3.6 ± 1 mg/kg in dogs with pyometra and 4.1 ± 1 in healthy controls (P = 0.37). In both groups, systolic blood pressure increased between phase 1 and 2, from 87 ± 15 to 114 ± 19 mmHg in dogs with pyometra, and from 88 ± 18 to 106 ± 20 mmHg in healthy controls, (both P < 0.0001). Systolic blood pressure did not differ significantly between groups in any of the phases. Heart rate and end-tidal concentration of isoflurane did not differ significantly between phases or between groups.ConclusionsThe increased blood pressure at removal of ovaries during ovariohysterectomy suggests a pronounced noxious stimulus at this part of the procedure. In principle, the study parameters and response to surgery did not differ significantly between dogs with pyometra and healthy controls.

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“…Surgical wounding (breaching the skin) prompts a unique physiological response that is designed to maintain blood volume and institute body defences and wound healing. Cortisol secretion is an important part of this physiological response, 36 which occurs even in the complete absence of pain, such as when patients are unconscious and/or under full general anaesthesia 37–40 . A more protracted cortisol response following surgical castration does not necessarily indicate greater or more protracted pain compared with rubber ring castration.…”

Section: Discussionmentioning

confidence: 99%

“…Cortisol secretion is an important part of this physiological response, 36 which occurs even in the complete absence of pain, such as when patients are unconscious and/or under full general anaesthesia. [37][38][39][40] A more protracted cortisol response following surgical castration does not necessarily indicate greater or more protracted pain compared with rubber ring castration. It may simply indicate that there has been a greater breach of the skin.…”

Section: Discussionmentioning

confidence: 99%

Topical anaesthesia alleviates short‐term pain of castration and tail docking in lambs

et al. 2010

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Depth of anesthesia with desflurane does not influence the endocrine‐metabolic response to pelvic surgery

Abstract: The results show that there is no relationship between the intra-operative level of anesthesia depth achieved with desflurane and the extent of endocrine-metabolic stress response.

Cited by 27 publications

References 19 publications

The Effects of Propofol and Isoflurane on Blood Glucose during Abdominal Hysterectomy in Diabetic Patients

The Effects of Propofol and Isoflurane on Blood Glucose during Abdominal Hysterectomy in Diabetic Patients

Blood pressure and heart rate during ovariohysterectomy in pyometra and control dogs: a preliminary investigation

Topical anaesthesia alleviates short‐term pain of castration and tail docking in lambs

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