The effect of combining different anaesthesia techniques on surgical stress and their markers in patients undergoing laparoscopic abdominal surgery.

Completed

Conditions: Calculus of gallbladder with acutecholecystitis, (2) ICD-10 Condition: N719||Inflammatory disease of uterus, unspecified, (3) ICD-10 Condition: K358||Other and unspecified acute appendicitis,

Brief Summary: Stress response due to surgical injury involves activation of inflammatory, endocrine, metabolic and immunologic mediators.1 However, exaggerated activation of various components can result in hemodynamic instability, and metabolic derangement leading to multiple organ failure and mortality.2 The magnitude of response is dependent on the severity, intensity and duration of stimulus. The general response is in the form of wide spread endocrinal, metabolic and biochemical reactions throughout the body using various mediators.3

All the intravenous agents and volatile anaesthetics in normal doses have minor influence on the endocrine and metabolic functions.4 Buyukkocak et al observed similar effect of General anaesthesia (GA) and Spinal Anaesthesia (SA) on stress response.5 Epidural anaesthesia along with general anaesthesia (GA) has shown to affect hormonal and metabolic stress response.6 General anaesthesia, total intravenous anaesthesia (TIVA) and spinal anaesthesia (SA) are also compared for reduction of stress response in laparoscopic cholecystectomy.7 Three different GA regimen and combination have shown different results on stress response.8

None of the studies have seen the effects of combining Peripheral nerve blocks (PNB) with different regimen. Pre-emptive analgesia with PNB is also unexplored. We shall see the effect of combining these different anaesthesia techniques on stress response and inflammatory markers.

Recruitment & Eligibility

Inclusion Criteria

Patients posted for elective laparoscopic abdominal surgeries under general anaesthesia.

Exclusion Criteria

Patients refusing to participate in the study, emergency surgeries, allergy to local anaesthetic drugs.

Primary Outcome Measures

Name	Time	Method
Effect of different anaesthesia practices on surgical stress and inflammatory markers IL-6, IL-10, TNF-Î±, C reactive protein and serum cortisol.	During perioperative period

Secondary Outcome Measures

Name	Time	Method
To find best possible combination for reduction of surgical stress response.	During perioperative period

Locations (1): All India Institute of Medical Sciences, Bhubaneswar
🇮🇳
Khordha, ORISSA, India
All India Institute of Medical Sciences, Bhubaneswar
🇮🇳Khordha, ORISSA, India
Dr Neha Singh
Principal investigator
9438884045
anaes_neha@aiimsbhubaneswar.edu.in