Large-dose intrathecal sufentanil prevents the hormonal stress response during major abdominal surgery: a comparison with intravenous sufentanil in a prospective randomized trial.

Abstract:

:We studied the effect of large-dose intrathecal sufentanil (ITS) for major abdominal surgery on the hormonal stress response. Forty patients were randomly allocated to receive either IV sufentanil (IVS) or 150 microg of ITS as part of general anesthesia. In the IVS group, adrenocorticotropic hormone (ACTH) and cortisol concentrations were larger than baseline and the ITS group, 60 min after incision and at skin closure. Plasma concentrations of cortisol and ACTH were not different from baseline in the ITS group during surgery. Six hours after skin closure, cortisol concentrations were larger than baseline in both groups. Twenty-four and 48 h after skin closure, ACTH and cortisol values were similar between groups. Norepinephrine concentrations increased after surgery in both groups. Blood glucose levels increased in both groups during and after surgery. Pain scores and morphine consumption during the first 48 h after surgery were lower in the ITS group. The data show that large-dose ITS prevents the intraoperative hormonal stress response in comparison with balanced anesthesia. We speculate that this is due to the highly specific binding of sufentanil to spinal and supraspinal receptors. This technique improves postoperative analgesia when compared with balanced anesthesia.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Borgdorff PJ,Ionescu TI,Houweling PL,Knape JT

doi

10.1213/01.ANE.0000131728.68125.4E

subject

Has Abstract

pub_date

2004-10-01 00:00:00

pages

1114-20, table of contents

issue

4

eissn

0003-2999

issn

1526-7598

pii

99/4/1114

journal_volume

99

pub_type

临床试验,杂志文章,随机对照试验
  • A laboratory evaluation of an auditory display designed to enhance intraoperative monitoring.

    abstract:UNLABELLED:Encouraged by the popularity of the pulse oximeter pulse-tone, we developed and tested an auditory display of six physiologic variables. The display consisted of a cardiovascular sound triggered by every heartbeat (conveying heart rate) and a respiratory sound triggered by every breath (conveying respiratory...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-200202000-00025

    authors: Loeb RG,Fitch WT

    更新日期:2002-02-01 00:00:00

  • Renal function and proteinuria after cardiopulmonary bypass: the effects of temperature and mannitol.

    abstract::We studied three groups of patients without previous renal impairment, undergoing elective coronary artery bypass surgery. Group H (n = 7) underwent open heart surgery using moderate hypothermia (28 degrees C); Groups N and M (n = 8, each) were managed at normothermia. The extracorporeal circuit was primed with Hartma...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1213/00000539-199405000-00004

    authors: Ip-Yam PC,Murphy S,Baines M,Fox MA,Desmond MJ,Innes PA

    更新日期:1994-05-01 00:00:00

  • The efficiency of CO2 elimination during high-frequency jet ventilation for laryngeal microsurgery.

    abstract:UNLABELLED:For adequate and safe use of high-frequency jet ventilation (HFJV), reliable monitoring of the PCO2 status and course is necessary. Because of improved handling and performance, recently available transcutaneous PCO2 monitoring devices such as MicroGas 7650 (Kontron Instruments Medical Sensors, Basel, Switze...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1097/00000539-199807000-00037

    authors: Biro P,Eyrich G,Rohling RG

    更新日期:1998-07-01 00:00:00

  • The effect of intravenous lidocaine on brain activation during non-noxious and acute noxious stimulation of the forepaw: a functional magnetic resonance imaging study in the rat.

    abstract:BACKGROUND:Lidocaine can alleviate acute as well as chronic neuropathic pain at very low plasma concentrations in humans and laboratory animals. The mechanism(s) underlying lidocaine's analgesic effect when administered systemically is poorly understood but clearly not related to interruption of peripheral nerve conduc...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ane.0b013e31818e0d34

    authors: Luo Z,Yu M,Smith SD,Kritzer M,Du C,Ma Y,Volkow ND,Glass PS,Benveniste H

    更新日期:2009-01-01 00:00:00

  • Plasma concentrations of lidocaine associated with cervical, thoracic, and lumbar epidural anesthesia.

    abstract::We measured arterial plasma concentrations of lidocaine by enzyme immunoassay when 10 ml of 2% lidocaine without epinephrine was injected into the cervical, thoracic, or lumbar epidural spaces in 30 patients. There was no difference in the time courses of plasma levels of lidocaine. Peak concentrations were achieved 1...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Mayumi T,Dohi S,Takahashi T

    更新日期:1983-06-01 00:00:00

  • The safety of immediate extubation after abdominal aortic surgery: a prospective, randomized trial.

    abstract:UNLABELLED:We performed this study to assess the safety of immediate extubation after elective abdominal aortic aneurysm surgery. Consecutive patients were prospectively randomized into two groups after surgery: Group 1 (n = 29) immediate extubation; and Group 2 (n = 21) delayed (at least 4 h) extubation. All patients ...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-200112000-00044

    authors: Cohen J,Loewinger J,Hutin K,Sulkes J,Zelikovski A,Singer P

    更新日期:2001-12-01 00:00:00

  • The use of a laryngeal mask airway after a prolonged suspension laryngoscopy to preserve a vocal cord fat graft.

    abstract::A 62-yr-old man presented for a microdirect laryngoscopy and vocal cord fat grafting under jet ventilation. After a prolonged laryngoscopy, the patient developed hypercapnea and upper airway obstruction secondary to traumatic epiglottitis. The placement of a laryngeal mask airway provided ventilation and allowed for d...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000286322.04940.a5

    authors: Kidani DC,Shah NK

    更新日期:2007-12-01 00:00:00

  • Ethanol enhances the functional recovery of stunned myocardium independent of K(ATP) channels in dogs.

    abstract::Chronic, intermittent exposure to small amounts of ethanol reduces myocardial infarct size in vivo. We tested the hypothesis that acute administration of ethanol enhances the functional recovery of stunned myocardium and that adenosine triphosphate-dependent potassium (K(ATP)) channels mediate this beneficial effect. ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-200102000-00003

    authors: Gross ER,Gare M,Toller WG,Kersten JR,Warltier DC,Pagel PS

    更新日期:2001-02-01 00:00:00

  • Myocardial Injury After Noncardiac Surgery: Preoperative, Intraoperative, and Postoperative Aspects, Implications, and Directions.

    abstract::Myocardial injury after noncardiac surgery (MINS) differs from myocardial infarction in being defined by troponin elevation apparently from cardiac ischemia with or without signs and symptoms. Such myocardial injury is common, silent, and strongly associated with mortality. MINS is usually asymptomatic and only detect...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审

    doi:10.1213/ANE.0000000000004567

    authors: Ruetzler K,Khanna AK,Sessler DI

    更新日期:2020-07-01 00:00:00

  • Gallamine administered by combined bolus and infusion.

    abstract::A technique combining an intravenous bolus and intravenous infusion regimen of gallamine based on its pharmacokinetics was developed to produce continuous relaxation during surgery. The combination of a bolus dose of gallamine, 2.5 mg/kg, and infusion, 0.8 mg/kg/hr, was tested in 11 patients. In 10 patients, surgery c...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Shanks CA,Funk DI,Avram MJ,Henthorn TK

    更新日期:1982-10-01 00:00:00

  • Technical communication: new teaching model for practicing ultrasound-guided regional anesthesia techniques: no perishable food products!

    abstract:BACKGROUND:There is a pronounced learning curve for the technique of ultrasound-guided regional anesthesia. Practicing with a simulator model has been shown to speed the acquisition of these skills for various ultrasound-guided procedures. However, commercial models for ultrasound-guided regional anesthesia may be too ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0b013e3181cc558b

    authors: Liu Y,Glass NL,Power RW

    更新日期:2010-04-01 00:00:00

  • Global end-diastolic volume during different loading conditions in a pediatric animal model.

    abstract:BACKGROUND:Estimating volume status in infants and neonates is challenging. Global end-diastolic volume (GEDV) and dynamic variables of preload, such as pulse pressure variation (PPV), may be alternative variables for estimating cardiac preload and fluid responsiveness. Therefore, we designed the present study to evalu...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000281152.72734.d0

    authors: Renner J,Meybohm P,Gruenewald M,Steinfath M,Scholz J,Boening A,Bein B

    更新日期:2007-11-01 00:00:00

  • Hemodynamic effects of portal triad clamping with and without pneumoperitoneum: an echocardiographic study.

    abstract::The decrease of cardiac index observed during portal triad clamping (PTC) with and without pneumoperitoneum has been studied only with right heart catheterization. To better understand this decrease of cardiac index, we investigated the balance between the adequacy of preload and the ability of the heart to pump again...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ANE.0000144592.20499.12

    authors: Decailliot F,Streich B,Heurtematte Y,Duvaldestin P,Cherqui D,Stéphan F

    更新日期:2005-03-01 00:00:00

  • Blood pressure, not cardiac output, determines blood loss during induced hypotension.

    abstract::Cardiac output characteristically decreases during trimethaphan infusion but is well maintained or increased during sodium nitroprusside infusion. We postulated that at similar levels of mean arterial pressure, sodium nitroprusside might be associated with greater blood loss than trimethaphan due to the increase in ca...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Sivarajan M,Amory DW,Everett GB,Buffington C

    更新日期:1980-03-01 00:00:00

  • Pharmacokinetics and pharmacokinetic-dynamic relationship between rapacuronium (Org 9487) and its 3-desacetyl metabolite (Org 9488).

    abstract:UNLABELLED:Rapacuronium (Org 9487) is a rapid-onset and short- to intermediate-acting muscle relaxant. Its 3-desacetyl metabolite, Org 9488, also exerts neuromuscular-blocking activity that may become apparent after prolonged maintenance of relaxation with rapacuronium. In this study, the pharmacokinetic behavior (n = ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199903000-00032

    authors: Schiere S,Proost JH,Schuringa M,Wierda JM

    更新日期:1999-03-01 00:00:00

  • Effects of Electrical Transcutaneous Vagus Nerve Stimulation on the Perceived Intensity of Repetitive Painful Heat Stimuli: A Blinded Placebo- and Sham-Controlled Randomized Crossover Investigation.

    abstract:BACKGROUND:Transcutaneous vagus nerve stimulation (TVNS) is a promising treatment for acute and chronic pain. However, experimental studies yielded controversial results. We examined if TVNS reduces the perceived intensity of repetitive painful heat stimulation and temporal summation of pain (TSP) in healthy volunteers...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/ANE.0000000000002820

    authors: Janner H,Klausenitz C,Gürtler N,Hahnenkamp K,Usichenko TI

    更新日期:2018-06-01 00:00:00

  • Transthoracic echocardiography simulation is an efficient method to train anesthesiologists in basic transthoracic echocardiography skills.

    abstract:BACKGROUND:The clinical utility of focused transthoracic echocardiography (TTE) is increasingly recognized in perioperative medicine. However its use is limited among anesthesiologists because of a lack of training. The most efficient training methods have not been determined. We hypothesized that simulation-based TTE ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/ANE.0b013e318265408f

    authors: Neelankavil J,Howard-Quijano K,Hsieh TC,Ramsingh D,Scovotti JC,Chua JH,Ho JK,Mahajan A

    更新日期:2012-11-01 00:00:00

  • The effect of lithotomy position on arterial blood pressure after spinal anesthesia.

    abstract::We compared the effect of the lithotomy position on the systolic blood pressure (SBP) with the horizontal position after spinal block. The lithotomy position was performed 5 min after spinal block. The change in SBP was expressed as percent of depression from the baseline value. The SBP increased by the lithotomy posi...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199507000-00019

    authors: Miyabe M,Sonoda H,Namiki A

    更新日期:1995-07-01 00:00:00

  • Clinical uses of the Bonfils Retromolar Intubation Fiberscope: a review.

    abstract::The Bonfils Retromolar Intubation Fiberscope is a rigid, straight fiberoptic device with a 40-degree curved tip, which facilitates targeted intubation. Bonfils, using a retromolar approach to intubate tracheas of children with Pierre Robin syndrome, was first described in 1983. After an initial steep learning curve, t...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审

    doi:10.1213/ANE.0b013e318265bae2

    authors: Thong SY,Wong TG

    更新日期:2012-10-01 00:00:00

  • The sevoflurane washout profile of seven recent anesthesia workstations for malignant hyperthermia-susceptible adults and infants: a bench test study.

    abstract:BACKGROUND:Preoperative flushing of an anesthesia workstation is an alternative for preparation of the anesthesia workstation before use in malignant hyperthermia-susceptible patients (MHS). We studied in vitro, using a test lung, the washout profile of sevoflurane in 7 recent workstations during adult and, for the fir...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000000208

    authors: Cottron N,Larcher C,Sommet A,Fesseau R,Alacoque X,Minville V,Fourcade O,Kern D

    更新日期:2014-07-01 00:00:00

  • The efficacy of the "BURP" maneuver during a difficult laryngoscopy.

    abstract::The displacement of the larynx in the three specific directions (a) posteriorly against the cervical vertebrae, (b) superiorly as possible, and (c) slightly laterally to the right have been reported and named the "BURP" maneuver. We evaluated the efficacy of the BURP maneuver in improving visualization of the larynx. ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199702000-00033

    authors: Takahata O,Kubota M,Mamiya K,Akama Y,Nozaka T,Matsumoto H,Ogawa H

    更新日期:1997-02-01 00:00:00

  • Pharmacodynamics and pharmacokinetics of epidural ropivacaine in humans.

    abstract::The purpose of this study was to characterize the pharmacodynamics and pharmacokinetics of three concentrations of the new long-acting amide local anesthetic, ropivacaine, given epidurally in 15 physical status ASA I or II patients for elective lower-extremity orthopedic procedures using a nonrandomized open-label des...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-199001000-00004

    authors: Katz JA,Bridenbaugh PO,Knarr DC,Helton SH,Denson DD

    更新日期:1990-01-01 00:00:00

  • Intrathecal midazolam II: combination with intrathecal fentanyl for labor pain.

    abstract:UNLABELLED:Recent investigations have sought to improve intrathecal analgesia by combining opioids with other classes of analgesics. In this study we assessed the ability of intrathecal midazolam to increase the potency and duration of the analgesic effects of intrathecal fentanyl without causing adverse effects. Thirt...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1213/01.ane.0000112434.68702.e4

    authors: Tucker AP,Mezzatesta J,Nadeson R,Goodchild CS

    更新日期:2004-06-01 00:00:00

  • The incidental finding of a patent foramen ovale during cardiac surgery: should it always be repaired? A core review.

    abstract::With the increased use of intraoperative transesophageal echocardiography, patent foramen ovale (PFO) has become a common finding during heart surgery. This finding presents a difficult dilemma for cardiac surgeons, since the impact of intraoperatively diagnosed PFOs on postoperative outcome is unknown. Changes in the...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审

    doi:10.1213/01.ane.0000278735.06194.0c

    authors: Sukernik MR,Bennett-Guerrero E

    更新日期:2007-09-01 00:00:00

  • The novel role of the mu opioid receptor in lung cancer progression: a laboratory investigation.

    abstract:BACKGROUND:The possibility that μ opioid agonists can influence cancer recurrence is a subject of recent interest. Epidemiologic studies suggested that there were differences in cancer recurrence in breast and prostate cancer contingent on anesthetic regimens. In this study, we identify a possible mechanism for these e...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0b013e31820568af

    authors: Mathew B,Lennon FE,Siegler J,Mirzapoiazova T,Mambetsariev N,Sammani S,Gerhold LM,LaRiviere PJ,Chen CT,Garcia JG,Salgia R,Moss J,Singleton PA

    更新日期:2011-03-01 00:00:00

  • Lidocaine enhances intraoperative ventricular defibrillation.

    abstract::The efficacy of lidocaine during myocardial reperfusion in coronary artery bypass surgery was evaluated in 20 patients randomly assigned to a control group (n = 10) or to receive lidocaine, 1 mg/kg intravenously 5 min before aortic unclamping and cardiac reperfusion, followed by infusion at 40 micrograms X kg-1 X min-...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Lake CL,Kron IL,Mentzer RM,Crampton RS

    更新日期:1986-04-01 00:00:00

  • Inhaled nitric oxide versus intravenous vasodilators in severe pulmonary hypertension after cardiac surgery.

    abstract:UNLABELLED:Inhaled nitric oxide (iNO) is superior to i.v. vasodilators for treatment of pulmonary hypertension (PH) after cardiac surgery, but iNO is a potentially toxic gas, and patient subsets who benefit from iNO are not yet clearly defined. We administered iNO 40 ppm, prostaglandin E1 (PGE1) 0.1 microg x kg(-1) min...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Schmid ER,Bürki C,Engel MH,Schmidlin D,Tornic M,Seifert B

    更新日期:1999-11-01 00:00:00

  • A Predictive Model for Extended Postanesthesia Care Unit Length of Stay in Outpatient Surgeries.

    abstract:BACKGROUND:A predictive model that can identify patients who are at an increased risk for prolonged postanesthesia care unit (PACU) stay could help optimize resource utilization and case sequencing. Although previous studies identified some predictors, there is not a model that only utilizes various patients demographi...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000001827

    authors: Gabriel RA,Waterman RS,Kim J,Ohno-Machado L

    更新日期:2017-05-01 00:00:00

  • Morphine kinetics and kidney transplantation: morphine removal is influenced by renal ischemia.

    abstract::Morphine plasma concentrations were determined in six patients receiving kidney transplants from living-related donors, and nine patients receiving kidney transplants from cadavers. The total cold ischemic time was about 2 hr for kidneys from living-related donors and 14 hr for those from cadavers. After an intravenou...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Sear J,Moore A,Hunniset A,Baldwin D,Allen M,Hand C,McQuay H,Morris P

    更新日期:1985-11-01 00:00:00

  • The interaction of FK409, a novel nitric oxide releaser, and peripherally administered morphine during experimental inflammation.

    abstract:UNLABELLED:Nitric oxide (NO) may play an important role in central and peripheral nociceptive processes. However, its contribution to peripheral antinociception is still not clear. In the present study, we investigated the effect of peripherally administered FK409, a spontaneous NO releaser, and its interaction with pe...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199802000-00028

    authors: Nozaki-Taguchi N,Yamamoto T

    更新日期:1998-02-01 00:00:00