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Stress indicators during general anesthesia with opioid analgesics in children

Biljana Draskovic1, Danica Stanic, Anna Uram-Benka

  • 1University of Novi Sad, Serbia.

Turkish Journal of Medical Sciences
|January 2, 2015
PubMed

Insights

Remifentanil effectively suppresses the surgical stress response in young boys undergoing common procedures. This opioid analgesic demonstrated superior efficacy compared to fentanyl and alfentanil with fewer side effects.

Area of Science:

  • Pediatric Anesthesiology
  • Surgical Stress Response
  • Pharmacology

Background:

  • Opioid analgesics are commonly used to manage pain and stress during pediatric surgery.
  • Different opioids may have varying effects on the physiological stress response.
  • Optimizing analgesic choice is crucial for minimizing adverse outcomes in children.

Purpose of the Study:

  • To compare the effectiveness of fentanyl, alfentanil, and remifentanil in blocking the surgical stress response in young boys.
  • To identify the opioid analgesic associated with the fewest side effects during day case surgery.

Main Methods:

  • Prospective, observational clinical study involving 150 boys aged 2-5 years.
  • Intravenous anesthesia with propofol, rocuronium, and opioids (fentanyl, alfentanil, or remifentanil).
  • Monitoring of stress markers including blood glucose, cortisone, and leptin levels.

Main Results:

  • Remifentanil group showed the lowest increase in cortisone levels.
  • Fentanyl group exhibited the highest blood glucose and cortisone levels.
  • Significant decrease in leptin was observed in the fentanyl and remifentanil groups at different time points.

Conclusions:

  • Remifentanil provides the most potent suppression of the surgical stress response in children.
  • The choice of opioid analgesic can significantly influence the physiological stress response to surgery.
Abstract

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