[Endocrine reaction pattern: midazolam-fentanyl anesthesia versus inhalation anesthesia]

Area of Science:

• Anesthesiology
• Endocrinology
• Metabolic Regulation

Background:

• Anesthesia choice impacts physiological responses during surgery.
• Understanding endocrine and metabolic changes is crucial for patient management.

Purpose of the Study:

• To compare the effects of midazolam-fentanyl-N2O/O2 and halothane-N2O/O2 anesthesia on endocrine and metabolic parameters.
• To evaluate the modulation of the organism's response to surgical stress by different anesthesia methods.

Main Methods:

• Randomized controlled study involving 16 orthopaedic patients.
• Measurement of plasma concentrations of ACTH, aldosterone, cortisol, 17-DHEA, insulin, prolactin, thyroid hormones (T3, T4, TBG), catecholamines (adrenaline, noradrenaline, dopamine), and metabolites (glucose, lactate, free glycerin, acetacetate).

Main Results:

• Significant differences observed in ACTH, aldosterone, cortisol, and 17-DHEA levels between anesthesia groups; prolactin also differed.
• Halothane anesthesia initially increased free T4 (FTI), but T3 levels did not show anesthesia-specific changes.
• Catecholamine levels peaked near operation end or post-extubation; insulin secretion remained unchanged during stress.
• Comparable increases in glucose, lactate, free glycerin, and acetacetate were noted with both anesthesia types.

Conclusions:

• Both midazolam-fentanyl-N2O/O2 and halothane-N2O/O2 anesthesia modulate endocrine and metabolic responses to surgical stress.
• No clinically relevant advantages or disadvantages were identified for either anesthesia method based on the measured parameters.