The evaluation of hemodynamic, endocrine response and nesfatin-1 i̇n patients who applied with inhalation and total intravenous anesthesia

In this study, it is aimed to analyze the effect of various anesthesia techniques on surgical stress response and the levels of nesfatin-1 which is a peptide hormone. In operating rooms of Fırat University Hospital 90 patients in the risk group of ASA I-II who will have septorhinoplasty surgery between March and June 2015, whose surgery will last at least for two hours, who do not have psychiatric, cardiovascular and metabolic disorders, who are between the ages of 18 and 60, who are unpremedicated were included in the study. The patients were divided into three groups as receiving Desfluran + N2O (Group 1), receiving Desfluran + Remifentanil (Group 2) and receiving Propofol + Remifentanil (Group3). By taking at least 5 ml venous blood samples three times, in the 30th minute in postoperative recovery room and in postoperative 24th hour from the patients in all groups shortly before induction, the levels of serum insulin, glucose, adrenalin, noradrenalin, cortisol and nesfatin-1 were analyzed. In our study, there was not a significant difference among the groups in terms of systolic blood pressure, pulse rates, the levels of glucose, serum adrenalin, noradrenalin and serum nesfatin. A significant increase in serum insulin levels in Group 1 in the third period was determined when compared to Group 3 (p<0.05). As for serum cortisol levels, a statistically significant increase in Group 3 in the second period in comparison with the other groups (p<0.05). As a conclusion, it was agreed that we need more extensive studies so as to clearly reveal the correlation between nesfatin-1 and surgical stress besides the fact that the various anesthesia techniques we apply to the patients have similar hemodynamic and endocrine responses. Key Words: Stress response to surgery, TIVA, inhalation anesthesia, Nesfatin-1