Stress response to propofol versus isoflurane anesthesia in patients undergoing gastric surgery

To compare the effects of propofol and isoflurane anesthesia on cortisol, insulin, and blood glucose levels surrounding operation period in patients undergoing gastric surgery. Study Design: An experimental study. Place and Duration of Study: The Department of Anesthesiology, Hubei Cancer Hospital, Wuhan, China, from October 2016 to January 2018. Methodology: A total of 86 patients, undergoing for gastric surgery, were divided randomly into propofol group and isoflurane group with 43 cases in each group. Propofol group used total intravenous anesthesia of propofol and isoflurane group used total intravenous anesthesia of isoflurane. Operation time, serum cortisol, insulin, and blood glucose levels were compared at 5 minutes before anesthesia (T1), 1-hour after anesthesia (T2), 1-hour after the operation (T3) and 48 hours after operation (T4). Results: There was no significant difference in operation time between two groups (p=0.642). At T1, there were no significant differences in level of serum cortisol, blood glucose, and insulin between two groups (p=0.644, 0.534 and 0.913, respectively). At T2, T3, T4, serum cortisol and blood glucose in propofol group were having less increasing pattern, and were lower than those in isoflurane group (all p<0.001), while insulin levels in propofol group were higher than those in isoflurane group (all p<0.001). Conclusion: Propofol can promote the secretion of insulin during radical gastrectomy, and inhibit the excessive secretion of cortisol and hyperglycemia. Either propofol or sevoflurane, to certain extent, can affect patients' stress response when they are applied in patients undergoing for gastric surgery. However, the influence of propofol on stress response is relatively smaller. (author)