Assesment of Serum Norephinephrine and Serum Glucose level during Laparoscopic Hysterectomy using different anaesthetic techniques

Sudeep Mohapatra; Shaswat Pattnaik; Pratibha Jena

Volume : IX, Issue : III, March - 2019

Assesment of Serum Norephinephrine and Serum Glucose level during Laparoscopic Hysterectomy using different anaesthetic techniques

Sudeep Mohapatra, Shaswat Pattnaik, Pratibha Jena

Abstract :

Background: The use of laparoscopy has revolutionised the surgical field with its advantages of reduced morbidity with early recovery, it is associated with reduced surgical trauma, and therefore with a less acute phase response, as compared with open surgery. Stress response to pneumoperitoneum in laparoscopic activates hypothalamic–pituitary–adrenal axis and the sympathetic nervous system with increase concentration of various stress hormones such as serum norepinephrine and decrease response to insulin. Material and methods: This is a prospective randomized study conducted at IMS & SUM hospital from January 2017 to December 2017. Patients undergoing elective laparoscopic hysterectomy over the study period were included and divided in two groups, Group A {n=50} received both General and Spinal anesthesia while Group B {n=50} received only General Anesthesia. Neuroendocrine Stress response to laparoscopic hysterectomy was studied by estimation of Serum Noradrenaline and serum glucose. Blood samples were collected at following time interval i.e. in the preoperative room BL, 5 min, 15 min, 30min, 45min and 60 min after pneumoperitoneum. Result : There was significant increase in serum nor epinephrine and serum glucose level after the onset of pneumoperitoneum,than baseline level .The increase in stress hormones was statistically significant in Group receiving only General anaesthesia than in Group receiving both general anesthesia and subarachnoid block. Group A patients showed more stabilization of intraoperative neuroendocrine stress hormone than Group B. Conclusion: Subarachnoid block combined with general anaesthesia could significantly reduce the stress reaction induced by pneumoperitoneum, less anaesthesia complications, smooth intraoperative blood flow.