Abstract
Under surgical stress, activity in the sympatho-adrenal system is increased in proportion to the degree of such stress. Urine catecholamines (CAs) were estimated as an index of the average activity in the sympatho-adrenal system. Urine CAs were estimated from the urine accumulated over a certain period of time. The urine CAs were measured in the recovery room, and the degree of surgical stress on each organ was compared.
The study was performed on 149 patients, who showed no renal dysfunction and patients were divided into two groups, NLA (fentanyl-N2O-O2) group and GOE (enflurane-N2O-O2) group. The values of norepinephrine (NE) and epinephrine (Epi) were corrected with creatinine (creat.) and were expressed in ng/mg Great.
From the values of NE and Epi of the NLA group, it was found that surgical stress was the highest on a hepatectomy and a colectomy. Gastrectomy, pulmonary resection, cholecystectomy, total hip replacement, hysterectomy and thyroidectomy were foll-owed. Further, urine CA values in the NLA group showed a significantly higher value than in GOE group, whereas the use of pentazocine during 60 minutes in the recovery room was 5% for the NLA group and 59% for the GOE group. These results suggest that the pain and the increase of sympathetic activity are not necessarily proportional to each other.
