EFFECT OF HIGH-DOSE REMIFENTANIL FOR THE HORMONAL STRESS RESPONSE AND POSTOPERATIVE QOL IN GYNECOLOGIC SURGERY

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  • 婦人科開腹手術における，高用量レミフェンタニル投与の手術侵襲ストレス抑制作用，術後QOLに与える影響
  • フジンカ カイフク シュジュツ ニ オケル,コウヨウリョウ レミフェンタニル トウヨ ノ シュジュツ シンシュウストレス ヨクセイ サヨウ,ジュツゴ QOL ニ アタエル エイキョウ

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We evaluated the effect of the perioperative administration of two doses of remifentanil for the hormonal stress response and postoperative QOL. The prospective, randomized study included 24 ASA1-2 patients. All patients were scheduled for lower abdominal gynecologic surgery. General anesthetic used was remifentanil 0.25μg/kg/min (0.25γgroup) or 1.0μg/kg/min (1γgroup) as the perioperative opioid. Postoperative analgesia was obtained by 0.25% levobupibacaine titration with epidural anesthesia. Blood samples were obtained from each patient after anesthetic induction, at 10 min, 30 min, and before skin closure. Samples were subsequently analyzed for cathecolamine, ACTH, cortisol, blood sugar, and insulin. We also investigated the volume of infusion, urine output, and postoperative QOL. Cathecholamine, ACTH, cortisol, blood sugar and insulin levels were decreased at all sampling times compared with the baseline value in the 1γgroup. In particular, there was a significant decrease in NAd and DOA levels. The urine output was significantly larger in the 1γgroup. There were no differences in the postoperative QOL within both groups. These results show that high-dose remifentanil decreases the hormonal stress response in gynecologic surgery.

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