[Pediatric anesthesia and stress response].

Abstract

The hyperglycemic and adrenocortical responses to upper and lower abdominal surgery were studied in four groups of children. In F group, lower abdominal surgery was performed under light general anesthesia (halothane 0.3-0.5% plus nitrous oxide and oxygen) combined with intravenous injections of fentanyl 10-13 micrograms.kg-1. In L-E group, lower abdominal surgery was performed under light general anesthesia combined with lumbar epidural anesthesia (intermittent injections of 1.0% lidocaine). In T-E group, upper abdominal surgery was performed under light general anesthesia combined with thoracic epidural anesthesia (intermittent injections of 1.0% lidocaine). In H group, lower abdominal surgery was performed under general anesthesia (halothane 1.0-1.5% plus nitrous oxide and oxygen). The hyperglycemic and adrenocortical responses were inhibited in F group, suggesting that intravenous injections of fentanyl 10-13 micrograms.kg-1 prevented the endocrine-metabolic response. On the other hand, in other three groups, those responses were not inhibited. Therefore we must consider the concentration and the volume of lidocaine in epidural groups. But general anesthesia combined with epidural anesthesia had a excellent effect on the postoperative pain management.