scholarly journals Effects of Propofol versus Sevoflurane on Postoperative Pain and Neuroendocrine Stress Response in Oocyte Pickup Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Yavuz Orak ◽  
Fatma İnanç Tolun ◽  
Murat Bakacak ◽  
Aslı Yaylalı ◽  
Hakan Kıran ◽  
...  

Background. Pain aggravates the autonomic response to stress and raises neuroendocrine stress hormone levels. We compared the effects of propofol and sevoflurane on postoperative pain and neuroendocrine stress hormones. A prospective, randomized, and controlled trial was conducted with 60 patients. Methods. We randomly allocated patients to groups P (remifentanil/propofol, n = 30) and S (remifentanil/sevoflurane, n = 30). Preoperative blood samples were taken to measure serum adrenocorticotropic hormone (ACTH), corticotropin-releasing hormone (CRH), glucagon, cortisol, aldosterone, and prostaglandin E2 (PGE2) levels. Intraoperatively and postoperatively, clinical parameters were monitored at different time points. The hormone levels were again measured in the follicular fluid and blood postoperatively. Result. Demographic data were similar. The preoperative serum aldosterone levels were significantly higher in group P ( p = 0.001 ). Preoperative and postoperative serum ACTH, glucagon, cortisol, and PGE2 levels were significantly different in group P ( p = 0.009 , p = 0.004 , p = 0.029 , and p = 0.002 ); serum ACTH, glucagon, and PGE2 levels increased while serum cortisol levels decreased postoperatively. In group S, serum CRH and aldosterone levels, both increased in the postoperative period compared to the preoperative ( p = 0.001 , p = 0.006 ). Postoperatively, glucagon and PGE2 levels were both higher in group P than group S ( p = 0.019 , p = 0.015 ). In postoperative follicular fluid, glucagon and PGE2 levels were higher in group P, while cortisol levels were higher in group S ( p = 0.001 , p = 0.007 , and p = 0.001 ). Conclusion. The effects of anesthetic agents were different. In group P, in the preoperative and postoperative evaluation, ACTH, glucagon, and PGE2 increased postoperatively, while cortisol decreased. In group S, aldosterone and CRH increased postoperatively. Glucagon and PG E2 were higher in group P than S, postoperatively.

2000 ◽  
Vol 36 (5) ◽  
pp. 448-455 ◽  
Author(s):  
CJ Reese ◽  
EJ Trotter ◽  
CE Short ◽  
HN Erb ◽  
LL Barlow

Twenty-one otherwise healthy dogs that presented for surgical repair of a ruptured cranial cruciate ligament were blindly and randomly given either carprofen (2.2 mg/kg body weight, orally) or a placebo beginning 12 hours preoperatively and continuing every 12 hours for a total of three doses. The patients were assessed for postoperative pain using a subjective pain score and given oxymorphone (0.1 mg/kg body weight, intramuscularly) every four hours if the pain score was 2 or greater. Blood samples were also collected to determine serum cortisol levels. There was a significant increase in serum cortisol levels in the immediate postoperative period in both the placebo group and the carprofen group (p less than 0.05). There was no significant difference in the percentage of increase in serum cortisol levels between the two groups. No correlation was evident between the serum cortisol levels and the corresponding pain scores in either group. This subjective method of assessing postoperative pain was not accurate and should not be relied upon for determination of postoperative analgesic administration. Perioperative oral administration of carprofen did not appear to be effective in controlling postoperative pain in these patients.


1977 ◽  
Vol 84 (3) ◽  
pp. 600-604 ◽  
Author(s):  
Anthony L. Barbato ◽  
Richard L. Landau

ABSTRACT Six patients with long-standing idiopathic primary adrenal insufficiency were given 25 mg of cortisone acetate orally on two occasions. Circulating serum cortisol levels were determined hourly for five hours after ingestion. Two patients were additionally studied with an oral dose of 20 mg of cortisol. Marked patient to patient variation in peak hormone and in fifth hour hormone levels was observed. Both values were lowest in the two chronically symptomatic patients who had been maintained on empiric glucocorticoid replacement. Specific information on blood cortisol levels in treated Addisonian individuals has not been previously reported.


1997 ◽  
Vol 15 (1) ◽  
pp. 2-5 ◽  
Author(s):  
LU Roth ◽  
A Maret-Maric ◽  
RH Adler ◽  
BE Neuenschwander

This randomised, controlled trial was to determine if blinded subjects are able to discriminate between needle stimulation at traditional acupuncture points and sham points, based on the appreciation of needling sensation (de qi); and if needling at traditional points is related to the objective parameter of serum cortisol increase. Manual acupuncture at traditional and sham points was applied to 20 healthy male students in a single-blind crossover design. Needle sensation (de qi) was reported as significantly stronger with traditional needling than with sham acupuncture. Needling at traditional acupuncture points moderately, but significantly, increased serum cortisol values at 5, 25 and 45 minutes after cessation of stimulation. Needle sensation did not correlate with serum cortisol levels. Experience of pain did not show a difference between traditional and sham needling, nor did it correlate with serum cortisol levels. We conclude that acupuncture points show subjective (needling sensation) and objective (serum cortisol increase) specificity.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
C. M. Toledo-Corral ◽  
T. L. Alderete ◽  
M. M. Herting ◽  
R. Habre ◽  
A. K. Peterson ◽  
...  

Abstract Background Hypothalamic-pituitary-adrenal (HPA)-axis dysfunction has been associated with a variety of mental health and cardio-metabolic disorders. While causal models of HPA-axis dysregulation have been largely focused on either pre-existing health conditions or psychosocial stress factors, recent evidence suggests a possible role for central nervous system activation via air pollutants, such as nitrogen dioxide (NO2), ozone (O3) and particulate matter (PM). Therefore, in an observational study of Latino youth, we investigated if monthly ambient NO2, O3, and PM with aerodynamic diameter ≤ 2.5 (PM2.5) exposure were associated with morning serum cortisol levels. Methods In this cross-sectional study, morning serum cortisol level was assessed after a supervised overnight fast in 203 overweight and obese Latino children and adolescents (female/male: 88/115; mean age: 11.1 ± 1.7 years; pre-pubertal/pubertal/post-pubertal: 85/101/17; BMI z-score: 2.1 ± 0.4). Cumulative concentrations of NO2, O3 and PM2.5 were spatially interpolated at the residential addresses based on measurements from community monitors up to 12 months prior to testing. Single and multi-pollutant linear effects models were used to test the cumulative monthly lag effects of NO2, O3, and PM2.5 on morning serum cortisol levels after adjusting for age, sex, seasonality, social position, pubertal status, and body fat percent by DEXA. Results Single and multi-pollutant models showed that higher O3 exposure (derived from maximum 8-h exposure windows) in the prior 1–7 months was associated with higher serum morning cortisol (p < 0.05) and longer term PM2.5 exposure (4–10 months) was associated with lower serum morning cortisol levels (p < 0.05). Stratification by pubertal status showed associations in pre-pubertal children compared to pubertal and post-pubertal children. Single, but not multi-pollutant, models showed that higher NO2 over the 4–10 month exposure period associated with lower morning serum cortisol (p < 0.05). Conclusions Chronic ambient NO2, O3 and PM2.5 differentially associate with HPA-axis dysfunction, a mechanism that may serve as an explanatory pathway in the relationship between ambient air pollution and metabolic health of youth living in polluted urban environments. Further research that uncovers how ambient air pollutants may differentially contribute to HPA-axis dysfunction are warranted.


2019 ◽  
Vol 7 (4) ◽  
pp. 549-552 ◽  
Author(s):  
Mhamed Abdelraouf ◽  
Maged Salah ◽  
Mohsen Waheb ◽  
Ahmed Elshall

INTRODUCTION: Post-dural puncture headache (PDPH) is a common complication following neuraxial anaesthesia that increases the duration of hospital stay. AIM: This study aims to evaluate the effectiveness of injection of the dexamethasone-lidocaine mixture in suboccipital muscles treatment of PDPH after cesarean section. PATIENT AND METHODS: A group of 90 females with PDPH following cesarean section under spinal anaesthesia were randomly allocated into two equal groups: study group (Group S) and control group (group C). All patients received bilateral intramuscular (in the suboccipital muscle) (Group S) (n = 45) patients received lidocaine 40 mg (2 mL of 2% solution) and dexamethasone 8mg in a total volume of 4 mL; whilst, patients in the control group (group C) (n = 45) received 4 mL normal saline. The primary outcome is the Visual Analogue Score for a headache at 24 hours after injection. RESULTS: Demographic data and the baseline, headache score, neck muscle spasm, and nausea were comparable in both groups. Group S showed lower headache score compared to group C at all the post-injection time points. All patients in group S showed resolution of nausea after the intervention; while none of the control group showed any improvement. All patients of group C needed rescue analgesia; while only 6 (13.3%) patients in group S asked for an analgesic. Time to the first analgesic request was longer in group S compared to group C (10.17 ± 7.96 hours versus 1.00 ± 0.00 hours, P < 0.001). CONCLUSION: Ultrasound-guided injection of the dexamethasone-lidocaine mixture in suboccipital muscles is effective management of PDPH after CS.


2018 ◽  
Vol 58 (1) ◽  
Author(s):  
Andrei Pereira Pernambuco ◽  
Lucina de Souza Cota Carvalho ◽  
Luana Pereira Leite Schetino ◽  
Janaíne Cunha Polese ◽  
Renato de Souza Viana ◽  
...  

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