Von der präemptiven zur präventiven Analgesie

Nau, Carla

doi:10.1007/s00101-013-2250-2

Cited by 2 publications

(1 citation statement)

References 8 publications

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“…Surgical stress response is the main cause of postoperative dysfunction of various organs and systems, which dictates the need to find approaches to its correction [21]. In this regard, limiting the severity of the surgical stress response becomes one of the leading tasks of anesthesia and postoperative intensive care [22]. The response to «stress» begins with the activation of the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system.…”

Section: Discussionmentioning

confidence: 99%

Influence of Different Types of Anesthesia for Laparoscopic Hysterectomy on the Dynamics of Stress Hormones

Ткаченко

Zaychenko

2021

Eureka: HS

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The aim of the study – to evaluate the influence of different variants of anesthesia, including low-opioid (LOA) and opioid-free anesthesia (OFA), on the dynamics of the stress response during laparoscopic hysterectomy. Materials and methods: 102 patients were randomly allocated into 3 groups: 37 women assigned to receive a standard opioid-based anesthesia (OBA group), 33 women – LOA group and 32 patients OFA group. Results: The patients of OFA group after induction and intubation of the trachea showed a significant (p<0.05) increase in cortisol level by 155.4 % and 160.9 % compared with the OBA group and LOA group. After completion of the hysterectomy, regardless of the variant of anesthesia, the level of cortisol exceeded the preoperative one (pOBA=0.116, pLOA=0.049, pOFA=0.043). Two hours after surgery with standard anesthesia (OBA group) there was a further increase in the concentration of cortisol in the blood, exceeding the initial values by 142.9 % (p=0.043). Patients in the LOA group and OFA group tended to decrease cortisolemia. The changes in adrenaline & glucose levels were somewhat similar. Conclusion: Use of OFA is accompanied by an aggravation of the stress response at the stage of hysterectomy, which is manifested by an increase in the level of adrenaline and cortisol. The most adequate perioperative protection is inherent in low-opioid anesthesia, which is accompanied by a lower release of stress hormones during hysterectomy and in the postoperative period. Opioid-based anesthesia provides adequate intraoperative protection, but is accompanied by insufficient postoperative analgesia.

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Section: Discussionmentioning

confidence: 99%