Substrate mobilisation during surgery. A comparison between halothane and fentanyl anaesthesia

Area of Science:

• Anesthesiology
• Endocrinology
• Surgical Metabolism

Background:

• Surgical procedures trigger significant metabolic and hormonal stress responses.
• Nitrous oxide and oxygen anesthesia is commonly used, but its supplementation impacts patient response.
• Halothane and fentanyl are anesthetic agents with potentially different effects on stress pathways.

Purpose of the Study:

• To compare the metabolic and hormonal effects of halothane versus fentanyl supplementation during nitrous oxide and oxygen anesthesia.
• To evaluate the impact of these anesthetic regimens on key stress markers during gynecological surgery.

Main Methods:

• Twenty-eight patients undergoing gynecological surgery were studied.
• Anesthesia was maintained with nitrous oxide and oxygen, supplemented with either 0.5-1.0% halothane or 50 microgram/kg fentanyl.
• Blood glucose, plasma cortisol, and growth hormone levels were measured.

Main Results:

• Patients receiving halothane showed significant increases in blood glucose, plasma cortisol, and growth hormone.
• These increases were completely abolished in patients who received fentanyl supplementation.
• Fentanyl effectively blunted the hormonal and metabolic stress response to surgery.

Conclusions:

• High-dose fentanyl can inhibit the cortisol and growth hormone response to surgical stress.
• Fentanyl supplementation may be a valuable strategy for ameliorating the catabolic response to surgical trauma.
• This highlights the potential of specific anesthetic agents in modulating the patient's physiological response to surgery.