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Epidural ropivacaine and sufentanil and the perioperative stress response after a radical retropubic prostatectomy

Authors
 J.-Y. HONG  ;  S. C. YANG  ;  J. YI  ;  H. K. KIL 
Citation
 ACTA ANAESTHESIOLOGICA SCANDINAVICA, Vol.55(3) : 282-289, 2011 
Journal Title
 ACTA ANAESTHESIOLOGICA SCANDINAVICA 
ISSN
 0001-5172 
Issue Date
2011
MeSH
Aged ; Amides/administration & dosage* ; Analgesia, Epidural* ; Analgesics, Opioid/administration & dosage* ; Anesthetics, Local/administration & dosage* ; Blood Pressure/drug effects ; Double-Blind Method ; Heart Rate/drug effects ; Humans ; Hydrocortisone/blood ; Male ; Pain, Postoperative/prevention & control ; Prostatectomy* ; Stress, Psychological/prevention & control* ; Sufentanil/administration & dosage*
Abstract
BACKGROUND: The effects of an epidural opioid and a local anesthetic on the perioperative stress responses have not been fully investigated in elderly patients undergoing cancer surgery. We hypothesized that the stress response after a radical retropubic prostatectomy (RRP) would be attenuated by epidural ropivacaine and sufentanil. METHODS: In this randomized, double-blinded study, we included patients above 65 years of age who were scheduled for a RRP. In addition to general anesthesia, they received either epidural saline continuously (5 ml/h) (C group, n=20); 0.3% ropivacaine (R group, n=20); or 0.3% ropivacaine combined with 1 μg/ml sufentanil (RS group; n=20). We determined the concentrations of glucose, insulin, cortisol, epinephrine, norepinephrine, and prolactin before, during, and up to 48 h after surgery. RESULTS: The concentrations of glucose and insulin increased in all the groups. The cortisol level increased in the C group while it decreased significantly in the RS group. Epinephrine and norepinephrine concentrations increased significantly after surgery in the C group, but not in the R and RS groups. The prolactin concentration increased in all the groups, and was higher in the RS group than in the other groups (P=0.002). Post-operative pain scores and analgesic requirement were lower in the R and RS groups. CONCLUSION: Epidural ropivacaine blunted the perioperative stress responses in elderly patients undergoing a RRP. The combination of epidural ropivacaine and sufentanil was associated with the most pronounced attenuation of the stress response. ClinicalTrial.gov registration number: NCT01086956.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/j.1399-6576.2010.02360.x/abstract
DOI
10.1111/j.1399-6576.2010.02360.x
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Kil, Hae Keum(길혜금)
Yang, Seung Choul(양승철)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/92626
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