Özet:

Aim: To compare the effects of general anesthesia alone and general anesthesia-epidural anesthesia combination on hemodynamic responses and stress response including cortisol, prolactine, and blood glucose levels in patients undergoing major abdominal and urological surgery. Material and method: 48 ASA I patients aged 22-70 years old were divided randomly into general anesthesia (Group GA) and general anesthesia + epidural anesthesia combination (Group GA+EA) groups. Patients in Group GA+EA received epidural anesthesia with 0.5% bupivacaine. The MAP, HR and SpO2 values of the patients were recorded preoperatively. First blood samples to measure basal cortisol, prolactine, and blood glucose levels were also taken preoperatively. Thiopental and vecuronium bromide were used for anesthesia induction and sevoflurane in O2 + N2O was used for anesthesia maintenance. Blood samples to measure cortisol, prolactine, and blood glucose levels were taken immediately after skin incision and 30 minutes after skin incision. The MAP, HR and SpO2 values were recorded immediately after skin incision, 30 and 60 minutes after skin incision, at the end of the operation, 10 and 30 minutes after the operation. Findings: There was no statistically significant difference between the groups in terms of cortisol and prolactine values. In Group GA+EA cortisol values immediately after skin incision and 30 minutes after skin incision were higher than the basal values. In all patients prolactine values immediately after skin incision and 30 minutes after skin incision were higher than the basal values. Blood glucose levels before induction and immediately after skin incison were similar both intergrouply and intragrouply. In Group GA blood glucose levels 30 minutes after skin incision were statistically significantly higher than Group GA+EA and in both groups these values were statistically significantly higher than the basal values. MAP values in Group GA were higher than the MAP values of Group GA+EA before induction, 30 and 60 minutes after skin incision, at the end of the operation, 10 and 30 minutes after the operation. It was concluded that general anesthesia-epidural anesthesia combination had minimal effects on hemodynamic stability and was insufficient to suppress stress response.

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