Efficacité protectrice de trois méthodes anesthésiques àl'égard du stress chirurgical chez l'enfant

G. Ivani, M. Vaira, S. Fossa, G. Mattioli, V. Jasonni, P. E. Caffarena, E. Podestà, E. Parodi, L. Rossi

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Hormonal-metabolic stress responses have bevond doubt an effect on morbidity/mortality related to surgery. The present study aimed to determine which anaesthetic technique could afford the best protection in children, through analysis of the perioperative Cortisol, prolactin and beta-endorphin plasma levels. Thirty-six young patients 3-10 years old, ASA I-II, scheduled for hypospadias or vesicoureteral reflux surgery of a duration > 60 min, were randomized into three groups (n = 12). Children of group 1 were given initially propofol and fentanyl then isoflurane 1% ; group 2 received TIVA with propofol and fentanyl, group 3 received initially propofol then an epidural lumbar block with bupivacaine 0.25% (single shot) and continuous propofol i.v. infusion. Cortisol, prolactin and beta-endorphin levels increased significantly in group 1 only. No significant differences were observed between groups 2 and 3. Early postoperative analgesia was better in group 3. These data suggest that TIVA and particularly epidural block could afford a better protection against the surgical stress in children submitted to subumbilical operations.

Original languageFrench
Pages (from-to)297-302
Number of pages6
JournalCahiers d'Anesthesiologie
Issue number4
Publication statusPublished - 1996

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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