Large-dose intrathecal sufentanil prevents the hormonal stress response during major abdominal surgery: a comparison with intravenous sufentanil in a prospective randomized trial.

Anesthesia and Analgesia
Paul J BorgdorffJohannes T A Knape

Abstract

We studied the effect of large-dose intrathecal sufentanil (ITS) for major abdominal surgery on the hormonal stress response. Forty patients were randomly allocated to receive either IV sufentanil (IVS) or 150 microg of ITS as part of general anesthesia. In the IVS group, adrenocorticotropic hormone (ACTH) and cortisol concentrations were larger than baseline and the ITS group, 60 min after incision and at skin closure. Plasma concentrations of cortisol and ACTH were not different from baseline in the ITS group during surgery. Six hours after skin closure, cortisol concentrations were larger than baseline in both groups. Twenty-four and 48 h after skin closure, ACTH and cortisol values were similar between groups. Norepinephrine concentrations increased after surgery in both groups. Blood glucose levels increased in both groups during and after surgery. Pain scores and morphine consumption during the first 48 h after surgery were lower in the ITS group. The data show that large-dose ITS prevents the intraoperative hormonal stress response in comparison with balanced anesthesia. We speculate that this is due to the highly specific binding of sufentanil to spinal and supraspinal receptors. This technique improves postoperative an...Continue Reading

References

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Citations

Feb 6, 2010·Southern Medical Journal·Ali Reza BameshkiPatricia Khashayar
Oct 16, 2007·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Xavier CulebrasEduardo Schiffer
Sep 27, 2012·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·B GoetzM S Kasparek
Feb 22, 2011·Acta Obstetricia Et Gynecologica Scandinavica·Ninnie Borendal WodlinUNKNOWN 'GASPI' Study Group
Dec 18, 2013·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·B GoetzM S Kasparek
Jul 26, 2005·Peptides·Richard J Bodnar, Gad E Klein
Aug 26, 2006·Anesthesia and Analgesia·Leanne Groban, John Butterworth

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