ABSTRACT

In this study we aimed to assess the effects of two different anesthesia induction techniques (Total intravenous anesthesia; TIVA) and (Volatile induction and maintenance anesthesia; VIMA) on autonomic and neuroendocrine stress response occurring after endotracheal intubation and skin incision. Sixty two ASA I-II patients aged between 18 to 55 years were included in the study. Cases were randomly divided into two groups of TIVA (propofol and remifentanyl; n=29) and VIMA (sevoflurane; n=33). Bispectral index monitorization was used to measure the depth of anesthesia. In both groups heart rate and mean arterial blood pressure were measured to assess autonomic response, and plasma concentrations of cortisol and noradrenaline were measured to assess hormonal response. Bispectral index values after endotracheal intubation and skin incision in both groups were within the levels suggested for a surgical intervention (45-60). Heart rate and mean arterial blood pressure decreased significantly in the TIVA group (p<0.001). Hormonal stres response was suppressed in both groups and especially in the TIVA group. In conclusion sevofluran administration (VIMA group) was found to be a safe induction technique providing the control of hormonal response developing against noxious stimuli without hemodynamic unstability. We think that this safe induction method may also be an alternative technique in high risk patients (such as hypertension and ischemic heart disease) sensitive against noxious stimuli.