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PubMed1982

[Hemodynamic and hormonal study of electronarcosis and neuroleptanalgesia. Clinical study in 17 surgical patients].

The blocking effect of electropharmaceutical anesthesia (EPA) and neuroleptanalgesia (NLA) on adrenergic and hormonal reactions to abdominal surgery were compared in 17 ASA class I to III randomized patients. This study was intended to define the indications for each of these techniques in patients with heart diseases. Each individual received the same anesthetic premedication and induction and was submitted to iterative identical measurements and biological dosages. Before and during surgery, both groups were catheterized with a Swan-Ganz and a radial catheter. Blood sampling for catecholamines, cortisol, glycemia, blood gases dosages were regularly drawn. Electrical stimulation was performed in the EPA group, and fentanyl injections were repeated in the NLA group patients only. The same doses of pancuronium and droperidol were given to every patient. A circulatory hyperkinesia and hyperadrenergia were observed during surgery in all of the subjects but, during EPA, the tachycardia, the cardiac index and the rate-pressure product were higher than during NLA. The body temperature increased towards normal in EPA, not in NLA. Adrenergic and hormonal levels were equal in both groups. The slow variations of all the important parameters demonstrate that the measured phenomenons have a long time-course what legitimates this kind of prolonged on-the-spot observation. The role of droperidol, pancuronium and fentanyl in the observed variations is discussed. The characteristic high hyperkinesia in EPA may be due partly to an inefficacious analgesia because of the fentanyl suppression after induction, partly to the preserved thermogenesis partly to a direct effect of the electrical stimulation on cerebral tissues.

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