The effect of anesthesia type on stress hormone response: comparison of general versus thoracic epidural anesthesia on laparoscopic cholecystectomy surgery

At this study we aimed to compare the effects of general anesthesia and thoracic epidural anesthesia on stress response in patients with laparoscopic cholecystectomy surgery. Following approval from the local ethics committee and written informed consent for study participation was obtained, 40 patients ,aged between 18 and 75 years, ASA status of I-II and going on laparoscopic cholecystectomy surgery, were included in the study. Patients were randomly divided into 2 groups as Group G ( General Anesthesia Group) and Group E ( Epidural Anesthesia Group). Patients in Group G received standard general anesthesia. Patients in Group E received thoracic epidural anesthesia that applied at Th 7-8 space and propofol infusion. To compare effects of anesthesia methods on stress response, blood samples were taken at preoperative, 30 minutes after incision and after 30 minutes last suture at postoperative period for the assesment plasma ACTH, cortisol and adrenaline levels. There was no statistically significant difference in demographic and anesthesia data between groups. Intraoperative and postoperative ACTH, cortisol and adrenaline levels was statistically significant higher compared with preoperative levels in both groups (p<0,05). Intraoperative and postoperative ACTH and adrenaline levels were significantly lower in the Group E (p<0,05). There were no statistically significant difference in intraoperative and postoperative cortisol levels between groups (p>0,05). In conclusion, we conclude that thoracic epidural anesthesia may reduce stress response compared with general anesthesia in laparoscopic cholecystectomy. Keywords: Laparoscopic Cholecystectomy, Thoracic Epidural Anesthesia, Stress Response