Perioperative stress response in elderly patients for elective gastrectomy--the comparison between isoflurane anesthesia and sevoflurane anesthesia both combined with epidural anesthesia

The difference in stress responses between isoflurane anesthesia (I group) and sevoflurane anesthesia (S group) was studied. Twelve patients for elective gastrectomy were divided into two groups: S group, 7 patients, 78 +/- 4.3 years of age, and I group, 5 patients, 77.4 +/- 6.9 years of age. Anesthesia was induced by fentanyl, midazolam and sevoflurane or isoflurane with 100% oxygen. After laryngeal mask air way was inserted under spontaneous ventilation, anesthesia was maintained with air (3 l.min-1), oxygen (2 l.min-1), sevoflurane or isoflurane and epidural block. Vecuronium bromide was given during surgery when needed. The demographic data were not different between the two groups. During operation, it was confirmed that the responses of sympathetic nervous system (epinephrine, norepinephrine) and pituitary-adrenocortical system (ACTH, cortisol) were maintained in both groups. After operation plasma norepinephrine levels increased in both groups. Although the responses of I group tended to be stronger than that of S group, there was no significant difference between the two groups.