The study was designed to determine pre-, intra-and postoperative serum cortisol and prolactin (PRL) concentrations in patients subjected to low abdominal surgery under total intravenous anesthesia (TIVA) with propofol-fentanyl, and under general balanced anesthesia with isoflurane-fentanyl. The prospective study included 50 patients of both sexes, aged between 35 and 60 years, subjected to elective low abdominal surgery. Patients were randomly divided into two groups: an experimental group, consisting of 25 ASA I/II (American Society of Anesthesiologists I/II classification) patients treated under TIVA with propofol-fentanyl, and a control group consisting of 25 ASA I/II patients treated under balanced anesthesia with isoflurane-fentanyl. The length of the surgery and the degree of the surgical trauma did not differ significantly between the two anesthesia groups. Blood samples for cortisol and PRL measurements were drawn at exact time points: 30 minutes before the beginning of the surgery (T0), 30 minutes after the beginning of the surgery (T1), at the end of the surgery (T2), 2 hours after the surgery (T3), and 24 hours after the surgery (T4). Serum levels of cortisol and PRL were measured using commercially available kits. The results were evaluated with the nonparametric Mann-Whitney test. The serum concentration of cortisol measured at T1 time point in patients treated under TIVA was significantly lower (p=0.04) than that in patients treated under general balanced anesthesia. The average circulating levels of PRL measured at T1, T2 and T3 time points in patients treated under TIVA were significantly lower (p=0.003; p=0.002; p<0.05; respectively) than those in patients treated under balanced anesthesia. The results obtained suggest that the endocrine stress response developed in response to surgery is probably attenuated in patients treated under TIVA with propofol-fentanyl and, thus, that these patients are less stressed in comparison to patients treated under general balanced anesthesia with isoflurane-fentanyl.

Bac kgrou nd: To de ter mi ne pre-, in tra-and pos to pe ra ti ve se rum glu co se and lac ta te con cen tra tio ns in pa tien ts sub jec ted to low ab do mi nal sur ge ry un der to tal in tra ve nous anes the sia (TIVA) wi th pro po fo l-fen ta nyl, and in tho se under ge ne ral ba lan ced anes the sia wi th isofl u ra ne-fen ta nyl. Ma te ria ls and Met ho ds: This pros pec ti ve stu dy in clu ded 50 pa tien ts of both sexes, aged be tween 35 and 60 yea rs, sub jec ted to low ab do mi nal sur gery. Pa tien ts we re ran dom ly di vi ded in to two grou ps: expe ri men tal group of 25 ASA I/II (Ame ri can So cie ty of Anes the sio lo gis ts I/II clas si fi ca tion) pa tien ts trea ted un der TIVA, and con trol group of 25 ASA I/II pa tien ts trea ted un der ba lan ced anes the sia. The len gth of sur ge ry and the deg ree of sur gi cal trau ma did not diff er sig ni fi can tly be tween the two anes the sia grou ps of pa tien ts. Blood sam ples for glu co se and lac ta te mea su re men ts we re drawn at exa ct ti me poin ts: 30 mi nu tes be fo re the be gin ni ng of the sur ge ry (T0), 30 mi nu tes af ter the be gin ni ng of the sur ge ry (T1), at the end of the sur ge ry (T2), 2 hou rs af ter the sur ge ry (T3), and 24 hou rs af ter the sur ge ry (T4). Se rum le ve ls of gluco se and lac ta te we re mea su red usi ng com mer cial ly avai lab le ki ts.