Comparison of Propofol and Enflurane for General Anesthesia: Effect on Cortisol Level and Hemodynamic Response

Abstract

Surgety is a potent stimulus for the neurohormonal axis and it is important to know the influence of specific anesthetic procedures on those host responses. The purpose of this study was to compare the effect of total intravenous anesthesia of propofol with those of inhalation anesthesia on circulating cortisol concentration and hemodynamic responses during pre-induction (Tl), bolus injection of induction doses (T2), post-intubation (T3), skin incision (T4), after 30 minutes skin incision (T5) and in the recovery room after reversal of anesthesia and extubation (T6). Sixty patients of ASA class 1 or 2 schedule to undergo general anesthesia were allocated randomly to two groups. Group E was induced with pentotal sodium (5 mg/kg) and maintained with O2/N2O and 1.5-2 Vol/% enflurane, group P was induced with propofol (2 mg/kg) and maintained with O2/N2O and continuous infusion of propofol (initial rate is 10 mg/kg/hr for 10 minutes and then 8 mg/kg/hr). The results were as follows; 1) The changes of the plasma cortisol level, there were statistically difference between the E group and the P group in the skin incision and 30min. after (P<0.06). 2) The plasma cortisol level in the propofol group was significantly increased than eontrol value only 30 min. after reversal and extubation. 3) The plasma cortisol level in the enflurane group was continuously increased from post- intubation until the end of the experiment. 4) There were no significant difference in hemodynamic changes between the enflurane group and the propofol group.In condusion, total intravenous anesthesia of propofol have no suppressive cortisol production during sutgical stress