To determine which of the applied opioid analgesics brings the most powerful blockade of the stress response with the fewest side effects in children. Materials and methods: This was a prospective, observational clinical study. The study included 150 boys, aged 2-5 years, ASA I, who underwent herniectomy or orchidopexy in day case surgery. The introduction and maintenance of anesthesia was intravenous (propofol, rocuronium, and opioids); airway was maintained by laryngeal mask and ventilation by mixture of oxygen/air. Subjects were divided into 3 groups depending on the applied opioid analgesics (fentanyl, alfentanil, remifentanil). Results: The fentanyl group had the highest blood glucose values (AS = 5.14; SD = 0.47) and the highest increase in cortisone level at the moment of incision and at awakening (AS = 536.09; SD = 198.56). The lowest increase in cortisone was recorded in the remifentanil group. A significant decrease in leptin was registered at awakening in the fentanyl group and at the moment of incision in the remifentanil group (P = 0.939). Conclusion: Remifentanil is the opioid analgesic with the highest suppressing effect on the stress response to surgical intervention in children.
DRASKOVIC, BILJANA; STANIC, DANICA; URAM-BENKA, ANNA; and FABRI, IZABELA
"Stress indicators during general anesthesia with opioid analgesics in children,"
Turkish Journal of Medical Sciences: Vol. 44:
6, Article 28.
Available at: https://journals.tubitak.gov.tr/medical/vol44/iss6/28