Before the induction of anesthesia in patients scheduled for elective surgical stress and fluid restriction to investigate the effect of patient's clinic, endocrine responses and level of nesfatin

ABSTRACT BEFORE THE INDUCTION OF ANESTHESIA IN PATIENTS SCHEDULED FOR ELECTIVE SURGICAL STRESS AND FLUID RESTRICTION TO INVESTIGATE THE EFFECT OF PATIENT'S CLINIC, ENDOCRINE RESPONSES AND LEVEL OF NESFATIN The objective of the present study was to assess the effects of stress and fluid restriction before anesthesia induction on the clinical picture, endocrine responses, and levels of a newly defined peptide hormone, nesfatin. A total of 100 ASA I-II adult patients between 18 and 60 years of age with no psychiatric, cardiovascular or metabolic disorders and undergoing surgery at Fırat University Hospital between June and November 2013 were included in this study. Patients were categorized into fluid restriction (Group 1) and no-fluid restriction (Group 2) groups. These groups were further sub-categorized as those receiving pre-medication (Group 1A and Group 2A) and those receiving no pre-medication (Group 1B and Group 2B). State Trait Anxiety Inventory was administered to all patients by an independent member of the research team before the surgical procedure Also, blood samples 6-8 hours, 1 hour, and just before the induction were obtained in order to measure insulin, glucose, epinephrine, norepinephrine, cortisol and nesfatin levels. In both groups, the test score for the pre-operative anxiety was 44. While there were no differences serum insulin levels between the study groups, serum glucose levels were higher in Group 1A than in other groups (88.60 ± 29.55 mg/dl). Also, serum epinephrine level was higher in Group 1A (76.79 ± 16.61 pg/ml). Except for the 2nd stage of anesthesia, serum norepinephrine levels were elevated in all stages (753.48±188.72 pg/ml). Serum cortisol levels were higher in Group 2B (12.78 ±4.58 µg/dl), while serum nesfatin 1 levels were higher in Group 2A (21.08 ± 6.20 pg/ml). In conclusion, in addition to preoperative anxiety induced by surgery, further studies are warranted before firmer conclusions can be drawn regarding the association between nesfatin-1 and anxiety. Keywords: Surgery, premedication, fluid restriction, anxiety, nesfatin-1