CARDIOVASCULAR AND BIOCHEMICAL EVIDENCE OF STRESS DURING MAJOR SURGERY ASSOCIATED WITH DIFFERENT TECHNIQUES OF ANAESTHESIA

The relative merits of a potent tiarcotic and a spinal analgesicto affect the stress response to a standard operation have beenassessed. Forty-five fit patients scheduled for abdominal hysterectomywere allocated at random to three groups, referred to as standard(i.v. anaesthesia alone), spinal (spinal plus i.v. anaesthesia)and fentanyl (fentanyl plus i.v. anaesthesia) groups. In thedoses used, fentanyl produced the most effective attentuationof the cardiovascular, hormonal and metabolic responses to stress,but had the disadvantage of prolonged respiratory depression.Spinal anaesthesia gave only a modified blockade of the responseto stress and did not obtund the reponse to intubation.