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Influence of spinal and general anesthesia on the metabolic, hormonal, and hemodynamic response in elective surgical patients.

Milosavljevic SB, Pavlovic AP, Trpkovic SV, Ilić AN, Sekulic AD - Med. Sci. Monit. (2014)

Bottom Line: There was a statistically significant, positive correlation between serum cortisol levels and glycemia at all times observed (p<0.01).Systolic and diastolic AP did not differ significantly between the groups (p=0.191, p=0.101).SpO2 values did not differ significantly between the groups (p=0.081).

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, General Hospital, Kosovska Mitrovica, Serbia.

ABSTRACT

Background: The aim of the study was to determine the significance of spinal anesthesia in the suppression of the metabolic, hormonal, and hemodynamic response to surgical stress in elective surgical patients compared to general anesthesia.

Material and methods: The study was clinical, prospective, and controlled and it involved 2 groups of patients (the spinal and the general anesthesia group) who underwent the same surgery. We monitored the metabolic and hormonal response to perioperative stress based on serum cortisol level and glycemia. We also examined how the different techniques of anesthesia affect these hemodynamic parameters: systolic arterial pressure (AP), diastolic AP, heart rate (HR), and arterial oxygen saturation (SpO2). These parameters were measured before induction on anesthesia (T1), 30 min after the surgical incisions (T2), 1 h postoperatively (T3) and 24 h after surgery (T4).

Results: Serum cortisol levels were significantly higher in the general anesthesia group compared to the spinal anesthesia group (p<0.01). Glycemia was significantly higher in the general anesthesia group (p<0.05). There was a statistically significant, positive correlation between serum cortisol levels and glycemia at all times observed (p<0.01). Systolic and diastolic AP did not differ significantly between the groups (p=0.191, p=0.101). The HR was significantly higher in the general anesthesia group (p<0.01). SpO2 values did not differ significantly between the groups (p=0.081).

Conclusions: Based on metabolic, hormonal, and hemodynamic responses, spinal anesthesia proved more effective than general anesthesia in suppressing stress response in elective surgical patients.

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Related in: MedlinePlus

Comparison of glycemia between groups during the observed period. Glycemia was significantly higher in the general anesthesia group compared to the spinal anesthesia group (p<0.05). During the observed period serum glucose levels differ significantly (p<0.01) with a significant linear trend of decrease in glycemia (p<0.01) and a significant quadratic trend of increase in serum cortisol levels at T2, which in the further course of the period decreased in values (p<0.01). Glycemia was significantly lower in the spinal anesthesia group at times T2 and T3 (both p<0.05), while the difference was not statistically significant at the times T1 and T4 (both p>0.05). Changes in glycemia did not differ significantly over time for both groups (p=0.60).
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f2-medscimonit-20-1833: Comparison of glycemia between groups during the observed period. Glycemia was significantly higher in the general anesthesia group compared to the spinal anesthesia group (p<0.05). During the observed period serum glucose levels differ significantly (p<0.01) with a significant linear trend of decrease in glycemia (p<0.01) and a significant quadratic trend of increase in serum cortisol levels at T2, which in the further course of the period decreased in values (p<0.01). Glycemia was significantly lower in the spinal anesthesia group at times T2 and T3 (both p<0.05), while the difference was not statistically significant at the times T1 and T4 (both p>0.05). Changes in glycemia did not differ significantly over time for both groups (p=0.60).

Mentions: Glycemia values were statistically significantly increases 30 min after surgical incision (T2) in both groups, but at T3 and T4 glycemia decreased (Figure 2).


Influence of spinal and general anesthesia on the metabolic, hormonal, and hemodynamic response in elective surgical patients.

Milosavljevic SB, Pavlovic AP, Trpkovic SV, Ilić AN, Sekulic AD - Med. Sci. Monit. (2014)

Comparison of glycemia between groups during the observed period. Glycemia was significantly higher in the general anesthesia group compared to the spinal anesthesia group (p<0.05). During the observed period serum glucose levels differ significantly (p<0.01) with a significant linear trend of decrease in glycemia (p<0.01) and a significant quadratic trend of increase in serum cortisol levels at T2, which in the further course of the period decreased in values (p<0.01). Glycemia was significantly lower in the spinal anesthesia group at times T2 and T3 (both p<0.05), while the difference was not statistically significant at the times T1 and T4 (both p>0.05). Changes in glycemia did not differ significantly over time for both groups (p=0.60).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4199462&req=5

f2-medscimonit-20-1833: Comparison of glycemia between groups during the observed period. Glycemia was significantly higher in the general anesthesia group compared to the spinal anesthesia group (p<0.05). During the observed period serum glucose levels differ significantly (p<0.01) with a significant linear trend of decrease in glycemia (p<0.01) and a significant quadratic trend of increase in serum cortisol levels at T2, which in the further course of the period decreased in values (p<0.01). Glycemia was significantly lower in the spinal anesthesia group at times T2 and T3 (both p<0.05), while the difference was not statistically significant at the times T1 and T4 (both p>0.05). Changes in glycemia did not differ significantly over time for both groups (p=0.60).
Mentions: Glycemia values were statistically significantly increases 30 min after surgical incision (T2) in both groups, but at T3 and T4 glycemia decreased (Figure 2).

Bottom Line: There was a statistically significant, positive correlation between serum cortisol levels and glycemia at all times observed (p<0.01).Systolic and diastolic AP did not differ significantly between the groups (p=0.191, p=0.101).SpO2 values did not differ significantly between the groups (p=0.081).

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, General Hospital, Kosovska Mitrovica, Serbia.

ABSTRACT

Background: The aim of the study was to determine the significance of spinal anesthesia in the suppression of the metabolic, hormonal, and hemodynamic response to surgical stress in elective surgical patients compared to general anesthesia.

Material and methods: The study was clinical, prospective, and controlled and it involved 2 groups of patients (the spinal and the general anesthesia group) who underwent the same surgery. We monitored the metabolic and hormonal response to perioperative stress based on serum cortisol level and glycemia. We also examined how the different techniques of anesthesia affect these hemodynamic parameters: systolic arterial pressure (AP), diastolic AP, heart rate (HR), and arterial oxygen saturation (SpO2). These parameters were measured before induction on anesthesia (T1), 30 min after the surgical incisions (T2), 1 h postoperatively (T3) and 24 h after surgery (T4).

Results: Serum cortisol levels were significantly higher in the general anesthesia group compared to the spinal anesthesia group (p<0.01). Glycemia was significantly higher in the general anesthesia group (p<0.05). There was a statistically significant, positive correlation between serum cortisol levels and glycemia at all times observed (p<0.01). Systolic and diastolic AP did not differ significantly between the groups (p=0.191, p=0.101). The HR was significantly higher in the general anesthesia group (p<0.01). SpO2 values did not differ significantly between the groups (p=0.081).

Conclusions: Based on metabolic, hormonal, and hemodynamic responses, spinal anesthesia proved more effective than general anesthesia in suppressing stress response in elective surgical patients.

Show MeSH
Related in: MedlinePlus