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British Journal of Anaesthesia, 1988, Vol. 61, No. 5 575-582
© 1988 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

HIGH- AND LOW-DOSE FENTANYL ANAESTHESIA: HORMONAL AND METABOLIC RESPONSES DURING CHOLECYSTECTOMY

K. GIESECKE, M.D., B. HAMBERGER, M.D., P.-O. JÄRNBERG, M.D., C. KLINGSTEDT, M.D. and B. PERSSON, M.D.

Department of Anaesthesiology, Karolinska Hospital,Karolinska Institute Stockholm, Sweden
Department of Surgery, Karolinska Hospital, Karolinska Institute Stockholm, Sweden
Department of Anaesthesiology, South Hospital, Karolinska Institute Stockholm, Sweden
Department of Pediatrics, St Görans Hospital, Karolinska Institute Stockholm, Sweden

*Address for correspondence: Anestesikliniken, Karolinska sjukhuset, Box 60 500, S-104 01 Stockholm, Sweden.

We have compared two groups of patients given low- or highdose fentanyl anaesthesia. Arterial blood samples were collected for measurement of glucose, free fatty acids (FFA), glycerol, betahydroxy-butyrate, insulin, c-peptide, glucagon, human growth hormone (HGH), cortisol and adrenaline concentrations. After induction of anaesthesia, blood concentrations of most of these substances decreased. After the start of surgery the concentrations of cortisol, glucose, HGH, FFA and beta-hydroxy-butyrate increased significantly in the group anaesthetized with the lower dose of fentanyl. In the group that received high-dose fentanyl anaesthesia the plasma concentrations of almost all the hormones and substances measured remained relatively low. The differences between the two groups during surgery were significant for adrenaline (P < 0.001) and cortisol (P < 0.001). High-dose fentanyl appears to block the trauma-induced stress response seen in patients anaesthetized with low dose fentanyl.


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