[Analgesics and neuroendocrine response in heart surgery: III. Metabolic aspects]

A study done in 121 patients undergoing extracorporeal perfusion heart surgery for the correction of valvular cardiopathies. In a first stage, we evaluated, in 77 patients, the influence of different analgesics on renal function, acid-base balance, glucemia and lactic acid. Afterwards we completed our observation with analysis of insulin in 44 patients. We observed no important difference in glomerular filtration rate, urinary output per minute, acid-base equilibrium, or oxigenation, according to administration of the different analgesics. After the glucose overload which the extracorporeal perfusion imposes, we observed a better insulinic response and consequently a faster recuperation of normal levels of glucemia in patients who received Fentathienyl. The lowest response was obtained in patients anesthesized with Pentazocina. In view of these results we can affirm that analysis if the inter-relation between glucose and insulin is a good exponet for evaluation of the grade of analgesic protection, offered by a drug, against nociceptive stimuli triggered by surgery.