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4 - The effects of fentanyl and remifentanyl on the surgical stress response in patients undergoing cholecystectomy operation with sevoflurane anaesthesia
Mehrican Ergen, Sibel Oba, Özgür Özbağrıaçık, İnci Paksoy, Levent Şahin, Mustafa Tuygun
Objective: In this study, the effects of fentanyl and remifentanyl on the surgical stress response in patients undergoing cholecystectomy operation were compared.
Study design: 35 patients with ASA I-II physical status undergoing cholecystectomy were included in this study. The same general anaesthesia was given to patients which were double blind randomly divided into two groups. Group F (n=18) had Imcglkg fentanyl and until 20 seconds before the end of surgery lmcg/kg/h fentanyl was infused. Group R (n=17) had lmcg/kg remifentanil and until the end of surgery 0. 25mcg/kglmin remifentanyl was infused. MABP, HR values and blood cortisol, insuline, glucose, ACTH and GH levels were measured in four periods: 1. before the induction of anaesthesia, 2. before the surgical incision, 3. 10 minutes after the incision and 4. 20 minutes after extubation.
Results: During 2. and 3. period MABP, HR values were lower in Group R compared with Group F (p<0.05) and blood cortisol level was lower during 2. and 3. period in comparison with the first period. (p<0.001) There was no difference in the other stress parameters between the 2 groups
Conclusion: During cholecystectomy, remifentanyl provided more stable hemodynamics compared with fentanyl. There was no difference in stress response between the 2 groups and neither remifentanyl nor fentanyl was able to abolish stress response.
Keywords: cholecystectomy, remifentanyl, fentanyl, surgical stress response.
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