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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 systolic and diastolic AP between the groups during the observed period. Systolic AP was significantly higher in the general anesthesia group at times T2, T3 and T4 (p<0.05), while the difference was not statistically significant at time T1 (p=0.303). Diastolic AP in the general anesthesia group was significantly lower at time T1, while at times T2 and T3 diastolic AP is significantly higher compared to the spinal anesthesia group (both p<0.01). The difference in diastolic AP measurements was not statistically significant at time T4 (p=0.246). Changes in values of systolic and diastolic AP are statistically significant in the observed time for both groups (p<0.01). (* p<0.01 or p<0.05).
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f3-medscimonit-20-1833: Comparison of systolic and diastolic AP between the groups during the observed period. Systolic AP was significantly higher in the general anesthesia group at times T2, T3 and T4 (p<0.05), while the difference was not statistically significant at time T1 (p=0.303). Diastolic AP in the general anesthesia group was significantly lower at time T1, while at times T2 and T3 diastolic AP is significantly higher compared to the spinal anesthesia group (both p<0.01). The difference in diastolic AP measurements was not statistically significant at time T4 (p=0.246). Changes in values of systolic and diastolic AP are statistically significant in the observed time for both groups (p<0.01). (* p<0.01 or p<0.05).

Mentions: Systolic and diastolic AP did not differ significantly between the groups. In the observed period, systolic and diastolic AP were significantly different, with a significant linear trend of decreasing AP values, but there was no significant difference in the fluctuations at the points of measurement, of the values for systolic and diastolic AP (Figure 3).


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 systolic and diastolic AP between the groups during the observed period. Systolic AP was significantly higher in the general anesthesia group at times T2, T3 and T4 (p<0.05), while the difference was not statistically significant at time T1 (p=0.303). Diastolic AP in the general anesthesia group was significantly lower at time T1, while at times T2 and T3 diastolic AP is significantly higher compared to the spinal anesthesia group (both p<0.01). The difference in diastolic AP measurements was not statistically significant at time T4 (p=0.246). Changes in values of systolic and diastolic AP are statistically significant in the observed time for both groups (p<0.01). (* p<0.01 or p<0.05).
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Related In: Results  -  Collection

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

f3-medscimonit-20-1833: Comparison of systolic and diastolic AP between the groups during the observed period. Systolic AP was significantly higher in the general anesthesia group at times T2, T3 and T4 (p<0.05), while the difference was not statistically significant at time T1 (p=0.303). Diastolic AP in the general anesthesia group was significantly lower at time T1, while at times T2 and T3 diastolic AP is significantly higher compared to the spinal anesthesia group (both p<0.01). The difference in diastolic AP measurements was not statistically significant at time T4 (p=0.246). Changes in values of systolic and diastolic AP are statistically significant in the observed time for both groups (p<0.01). (* p<0.01 or p<0.05).
Mentions: Systolic and diastolic AP did not differ significantly between the groups. In the observed period, systolic and diastolic AP were significantly different, with a significant linear trend of decreasing AP values, but there was no significant difference in the fluctuations at the points of measurement, of the values for systolic and diastolic AP (Figure 3).

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