Laparoscopy — a stressful procedure

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Abstract
Summary: The metabolic and hormonal response to laparoscopy was investigated in 22 patients, in whom nitrous oxide‐oxygen anaesthesia was supplemented with either 150 μg fentanyl or an Althesin infusion. There were significant increases in plasma cortisol (p < 0.05) from 303 to 458 mmol/litre and prolactin from 1869 to 3918 mU/litre (p < 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 < 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 < 0.01). The blood glucose concentration increased significantly (p < 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.

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