Laparoscopy--a stressful procedure

The metabolic and hormonal response to laparoscopy was investigated in 22 patients, in whom nitrous oxide-oxygen anaesthesia was supplemented with either 150 micrograms fentanyl or an Althesin infusion. There were significant increases in plasma cortisol (p less than 0.05) from 303 to 458 mmol/litre and prolactin from 1869 to 3918 mU/litre (p less than 0.01) at the end of laparoscopy in both groups of patients; these were sustained during the first hour of the recovery period. The blood glucose concentration increased significantly (p less than 0.05) from 4.48 to 5.28 mmol/litre at the end of laparoscopy in the Althesin patients and remained increased 1 hour postoperatively at 5.54 mmol/litre (p less than 0.01). The blood glucose concentration increased significantly (p less than 0.05) from 4.43 to 5.36 mmol/litre in the fentanyl patients only during the recovery period. There was no significant difference between the metabolic and hormonal changes observed with the two anaesthetic techniques.