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British Journal of Anaesthesia, 1985, Vol. 57, No. 6 591-594
© 1985 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

EFFECT OF ALFENTANIL ANAESTHESIA ON THE ADRENOCORTICAL AND HYPERGLYCAEMIC RESPONSE TO ABDOMINAL SURGERY

I. W. MØLLER, M.D, T. KRANTZ, M.D., E. WANDALL, M.D. and H. KEHLET, M.D.

Department of Anaesthesiology, Bispebjerg Hospital, Copenhagen, and Hvidøre Hospital Klampenborg, Denmark

Correspondence to I.W.M. Department of Anaesthesiology, Bispebjerg Hospital, Bispebjerg Bakke 23, DK-2400 Copenhagen NV, Denmark.

Plasma concentrations of cortisol and glucose were measured from before to 9 h after skin incision in 24 patients undergoing abdominal hysterectomy. The patients were randomly allocated to receive either high-dose alfentanil anaesthesia (150 µg kg–1 initially, followed by continuous infusion at a rate of 3 µg kg–1 min–1) or neurolept anaesthesia (droperidol 0.25 mg kg–1 plus fentanyl 5 µg kg–1 initially, followed by intermittent incremental doses of fentanyl 50 µg). The intraoperative and initial postoperative increases in plasma cortisol and glucose concentrations were inhibited (P < 0.05) by alfentanil but, later in the postoperative period, both groups showed identical increases in cortisol and glucose concentrations. Mean arterial pressure and heart rate were more stable in the alfentanil group. The concept of "stress-free" anaesthesia during highdose opiate administration seems to be valid during operation and for the initial 1–3 h into the postoperative period.


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