Research Article
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The Evaluation of Hemodynamic and Endocrine Response and Nesfatin-1 in Patients Undergoing Inhalation and Total Intravenous Anesthesia

Year 2025, Volume: 9 Issue: 2, 142 - 152, 08.08.2025
https://doi.org/10.46332/aemj.1597215

Abstract

Purpose: The aim of this study was to investigate the effects of different anesthesia techniques on the surgical stress response and nesfatin-1 levels.

Materials and Methods: This prospective, randomized, controlled study was conducted between March and June 2015. Ninety patients undergoing septoplasty were randomized into three groups: Desflurane + N2O (Group 1), Desflurane + Remifentanil (Group 2), and Propofol + Remifentanil (Group 3). Blood samples were collected immediately before induction, at the 30th minute in the postoperative recovery room, and at the 24th postoperative hour. Serum insulin, glucose, adrenaline, noradrenaline, cortisol, and nesfatin-1 levels were measured.

Results: There were no significant differences between groups in glucose, adrenaline, noradrenaline, and nesfatin-1 levels at any time point (p > 0.05). However, insulin levels at the 24th postoperative hour were significantly higher in Group 1 compared to Group 3 (18.24 miu/ml vs. 5.52 miu/ml; p < 0.05). Cortisol levels measured at the 30th postoperative minute in Group 3 showed a significant increase compared to the other groups (10.82 μg/dl; p < 0.05).

Conclusion: Different anesthesia techniques produced similar effects on hemodynamic and endocrine responses as well as nesfatin-1 levels in patients undergoing septoplasty.

Ethical Statement

The ethics committee permission required for this study was obtained from Fırat University Faculty of Medicine Clinical Research Ethics Committee (decision no. 12-05 dated 17.06.2014).

Supporting Institution

Fırat University Scientific Research Projects Coordination Unit

Project Number

TF 14.55

References

  • 1. Kayhan Z. Metabolik/Endokrin Sistem ve Anestezi. Kayhan Z, ed. Klinik Anestezi. Türkiye: Logos Yayıncılık; 2004:406-416.
  • 2. Weissman C. The metabolic response to stress: an overview and update. Anesthesiology. 1990;73(2): 308-327.
  • 3. Ledowski T, Bein B, Hanss R, et al. Neuroendocrine stress response and heart rate variability: a comparison of total ıntravenous versus balanced anesthesia. Anesth Analg. 2005;101(6):1700-1705.
  • 4. Nishiyama T, Yamashita K, Yokoyama T. Stress hormone changes in general anesthesia of long duration: isoflurane-nitrous oxide vs sevoflurane-nitrous oxide anesthesia. J Clin Anesth. 2005;17(8):586-591.
  • 5. Kaş D, Gönüllü M, Kol İÖ. Farklı Anestezi Yöntemlerinin Cerrahi Stres Yanıt Üzerindeki Etkisi. Turk J Anaesthesiol Reanim. 2005;33:471-479.
  • 6. Tüfek A, Bilgin H, Özcan B, Türker G. Remifentanil ile kombine edilen sevofluran, desfluran veya propofol anestezisi: Derlenme özelliklerinin, komplikasyonların ve anestezik ilaç maliyetlerinin karşılaştırılması. Türk Anest Rean Der Dergisi. 2006;34(2):103-110.
  • 7. Tavlan A, Topal A, Tuncer S, Kara İ, Otelciorlu Ş. Remifentanil ile kombine edilen propofol ve desfluran anestezisinin hemodinami ve derlenme üzerine olan etkilerini karşılastırması Turkiye Klinikleri J Anest Reanim. 2006;4(3):95-100.
  • 8. Su Y, Zhang J, Tang Y, Bi F, Liu JN. The novel function of nesfatin-1: Antihyperglycemia. Biochem. Biophys. Res. Commun. 2010;391(1):1039-1042.
  • 9. Gonzalez R, Mohan H, Unniappan S. Nucleobindins: bioactive precursor proteins encoding putative endocrine factors? Gen Comp Endocrinol. 2012;176(3):341-346.
  • 10. Yosten GL, Samson WK. Nesfatin-1 exerts cardiovascular actions in brain: possible interaction with the central melano-cortin system. Am J Physiol Regul Integr Comp Physiol. 2009;297(2):330-336.
  • 11. Misiolek H, Wojcieszek E, Dyaczynska-Herman A. Comparison of influence of thiopentone, propofol and midazolam on blood serum concentration of noradrenaline and cortisol in patients undergoing non-toxic struma operation. Med Sci Monit. 2000;6(2):319-324.
  • 12. Giesecke K, Hamberger B, Järnberg PO, Klingstedt C, Persson B. High- and low-dose fentanyl anaesthesia: hormonal and metabolic responses during cholecystectomy. Br J Anaesth. 1988;61(1):575-582.
  • 13. Schrıcker T, Galeone M, Wykes L, Carli F. Effect of desflurane/remifentanil anaesthesia on glucose metabolism during surgery: a comparison with desflurane/epidural anaesthesia. Acta Anaesthesiol Scand. 2004;48(2):169-173.
  • 14. Billard V, Servin F, Guignard B, et al. Desfluraneremifentanil-nitrous oxide anaesthesia for abdominal surgery: optimal concentrations and recovery features. Acta Anaesthesiol Scand. 2004;48(3):355-364.
  • 15. Grundmann U, Silomon M, Bach F, et al. Recovery profile and side effects of remifentanil-based anaesthesia with desflu-rane or propofol for laparoscopic cholecystectomy. Acta Anaesthesiol Scand. 2001;45 (3):320-326.
  • 16. Riegler R, Neumark J, Spiss CK, Draxler V. Brief anesthesia with propofol. Anaesthesiol Reanim. 1987;12(4):207-211.
  • 17. Adams HA, Schmitz CS, Baltes-Gotz B. Endocrine stress reaction, hemodynamics and recovery in total intravenous and inhalation anesthesia. Propofol versus isoflurane. Anaesthesist. 1994;43(11):730-737.
  • 18. Tavlan A, Erol A, Topal A, Dayıoğlu M, Kara İ, Otelcioğlu E. İntrakraniyal kitle cerrahisinde propofol-remifentanil ile desfluran-remifentanil anestezisinin karşılaştırılması. Turk Anest Rean Dergisi. 2006;34:283-289.
  • 19. Ittichaikulthol W, Lekprasert V, Pausawasdi S, Suchartwatnachai P. Effect of intraoperative fluid on blood glucose level in neurosurgery. J Med Assoc Thai. 1997;80(7):461-465.
  • 20. Suchartwatnachai P, Kaewsing P. Effect of sevoflurane and isoflurane on blood glucose level in neurosurgery. Thai J Anesthesiol. 2003;29(4):198-203.
  • 21. Netter FH. The Ciba Collection of Medical Illustrations: Endocrine System and Selected Metabolic Diseases. 2nd printing. New York, USA: Photo Engraving Co; 1970:77-80.
  • 22. Laucoumenta S, Paterson JL, Burrin J. Effects of two different halothane concentrations on the metabolic and endocrine responses to surgery. Br. J. Anaesth. 1986;58(8):844-850.
  • 23. Malatinsky J, Vigas M, Jurcovicova J. The patterns of endocrine responses to surgical stress during different types of anesthesia and surgery in man. Acta Anesthesia Belg. 1986;37(1):23-27.
  • 24. Nakata M, Manaka K, Yamamoto S, Mori M, Yada T. Nesfatin-1 enhances glucose-induced insulin secretion by promo-ting Ca(2+) influx through L-type channels in mouse islet β-cells. Endocr J. 2011;58(4):305-313.

İnhalasyon ve Total İntravenöz Anestezi Uygulanan Hastalarda Hemodinamik, Endokrin Yanıt ve Nesfatin-1'in Değerlendirilmesi

Year 2025, Volume: 9 Issue: 2, 142 - 152, 08.08.2025
https://doi.org/10.46332/aemj.1597215

Abstract

Amaç: Çalışmanın amacı, farklı anestezi tekniklerinin cerrahi stres yanıtı ve nesfatin-1 düzeyleri üzerindeki etkilerini araştırmaktır.

Araçlar ve Yöntem: Bu çalışma, Mart-Haziran 2015 tarihleri arasında prospektif, randomize ve kontrollü olarak gerçekleştirildi. Septoplasti operasyonu geçiren 90 hasta, Desfluran + N2O (Grup 1), Desfluran + Remifentanil (Grup 2) ve Propofol + Remifentanil (Grup 3) olmak üzere üç gruba randomize edildi. Kan örnekleri indüksiyondan hemen önce, postoperatif derlenme odasında 30. dakikada ve postoperatif 24. saatte alındı. Serum insülin, glukoz, adrenalin, noradrenalin, kortizol ve nesfatin-1 düzeyleri ölçüldü.

Bulgular: Gruplar arasında glukoz, adrenalin, noradrenalin ve nesfatin-1 düzeyleri açısından herhangi bir zaman noktasında anlamlı fark gözlenmedi (p > 0,05). Ancak, postoperatif 24. saatte insülin düzeyleri Grup 1’de Grup 3’e kıyasla anlamlı derecede yüksekti (sırasıyla 18,24 miu/ml ve 5,52 miu/ml; p < 0,05). Postoperatif 30. dakikada Grup 3’te ölçülen kortizol seviyeleri diğer gruplara göre anlamlı bir artış gösterdi (10,82 μg/dl; p < 0,05).

Sonuç: Septoplasti geçiren hastalarda farklı anestezi teknikleri, hemodinamik ve endokrin yanıtlar ile nesfatin-1 düzeyleri üzerinde benzer etkiler göstermiştir.

Ethical Statement

Bu çalışma için gerekli olan etik kurul izni, Fırat Üniversitesi Tıp Fakültesi Klinik Araştırmalar Etik Kurulu’ndan (17.06.2014 tarih ve 12-05 karar no) alınmıştır.

Supporting Institution

Fırat Üniversitesi Bilimsel Araştırma Projeleri Koordinasyon Birimi

Project Number

TF 14.55

References

  • 1. Kayhan Z. Metabolik/Endokrin Sistem ve Anestezi. Kayhan Z, ed. Klinik Anestezi. Türkiye: Logos Yayıncılık; 2004:406-416.
  • 2. Weissman C. The metabolic response to stress: an overview and update. Anesthesiology. 1990;73(2): 308-327.
  • 3. Ledowski T, Bein B, Hanss R, et al. Neuroendocrine stress response and heart rate variability: a comparison of total ıntravenous versus balanced anesthesia. Anesth Analg. 2005;101(6):1700-1705.
  • 4. Nishiyama T, Yamashita K, Yokoyama T. Stress hormone changes in general anesthesia of long duration: isoflurane-nitrous oxide vs sevoflurane-nitrous oxide anesthesia. J Clin Anesth. 2005;17(8):586-591.
  • 5. Kaş D, Gönüllü M, Kol İÖ. Farklı Anestezi Yöntemlerinin Cerrahi Stres Yanıt Üzerindeki Etkisi. Turk J Anaesthesiol Reanim. 2005;33:471-479.
  • 6. Tüfek A, Bilgin H, Özcan B, Türker G. Remifentanil ile kombine edilen sevofluran, desfluran veya propofol anestezisi: Derlenme özelliklerinin, komplikasyonların ve anestezik ilaç maliyetlerinin karşılaştırılması. Türk Anest Rean Der Dergisi. 2006;34(2):103-110.
  • 7. Tavlan A, Topal A, Tuncer S, Kara İ, Otelciorlu Ş. Remifentanil ile kombine edilen propofol ve desfluran anestezisinin hemodinami ve derlenme üzerine olan etkilerini karşılastırması Turkiye Klinikleri J Anest Reanim. 2006;4(3):95-100.
  • 8. Su Y, Zhang J, Tang Y, Bi F, Liu JN. The novel function of nesfatin-1: Antihyperglycemia. Biochem. Biophys. Res. Commun. 2010;391(1):1039-1042.
  • 9. Gonzalez R, Mohan H, Unniappan S. Nucleobindins: bioactive precursor proteins encoding putative endocrine factors? Gen Comp Endocrinol. 2012;176(3):341-346.
  • 10. Yosten GL, Samson WK. Nesfatin-1 exerts cardiovascular actions in brain: possible interaction with the central melano-cortin system. Am J Physiol Regul Integr Comp Physiol. 2009;297(2):330-336.
  • 11. Misiolek H, Wojcieszek E, Dyaczynska-Herman A. Comparison of influence of thiopentone, propofol and midazolam on blood serum concentration of noradrenaline and cortisol in patients undergoing non-toxic struma operation. Med Sci Monit. 2000;6(2):319-324.
  • 12. Giesecke K, Hamberger B, Järnberg PO, Klingstedt C, Persson B. High- and low-dose fentanyl anaesthesia: hormonal and metabolic responses during cholecystectomy. Br J Anaesth. 1988;61(1):575-582.
  • 13. Schrıcker T, Galeone M, Wykes L, Carli F. Effect of desflurane/remifentanil anaesthesia on glucose metabolism during surgery: a comparison with desflurane/epidural anaesthesia. Acta Anaesthesiol Scand. 2004;48(2):169-173.
  • 14. Billard V, Servin F, Guignard B, et al. Desfluraneremifentanil-nitrous oxide anaesthesia for abdominal surgery: optimal concentrations and recovery features. Acta Anaesthesiol Scand. 2004;48(3):355-364.
  • 15. Grundmann U, Silomon M, Bach F, et al. Recovery profile and side effects of remifentanil-based anaesthesia with desflu-rane or propofol for laparoscopic cholecystectomy. Acta Anaesthesiol Scand. 2001;45 (3):320-326.
  • 16. Riegler R, Neumark J, Spiss CK, Draxler V. Brief anesthesia with propofol. Anaesthesiol Reanim. 1987;12(4):207-211.
  • 17. Adams HA, Schmitz CS, Baltes-Gotz B. Endocrine stress reaction, hemodynamics and recovery in total intravenous and inhalation anesthesia. Propofol versus isoflurane. Anaesthesist. 1994;43(11):730-737.
  • 18. Tavlan A, Erol A, Topal A, Dayıoğlu M, Kara İ, Otelcioğlu E. İntrakraniyal kitle cerrahisinde propofol-remifentanil ile desfluran-remifentanil anestezisinin karşılaştırılması. Turk Anest Rean Dergisi. 2006;34:283-289.
  • 19. Ittichaikulthol W, Lekprasert V, Pausawasdi S, Suchartwatnachai P. Effect of intraoperative fluid on blood glucose level in neurosurgery. J Med Assoc Thai. 1997;80(7):461-465.
  • 20. Suchartwatnachai P, Kaewsing P. Effect of sevoflurane and isoflurane on blood glucose level in neurosurgery. Thai J Anesthesiol. 2003;29(4):198-203.
  • 21. Netter FH. The Ciba Collection of Medical Illustrations: Endocrine System and Selected Metabolic Diseases. 2nd printing. New York, USA: Photo Engraving Co; 1970:77-80.
  • 22. Laucoumenta S, Paterson JL, Burrin J. Effects of two different halothane concentrations on the metabolic and endocrine responses to surgery. Br. J. Anaesth. 1986;58(8):844-850.
  • 23. Malatinsky J, Vigas M, Jurcovicova J. The patterns of endocrine responses to surgical stress during different types of anesthesia and surgery in man. Acta Anesthesia Belg. 1986;37(1):23-27.
  • 24. Nakata M, Manaka K, Yamamoto S, Mori M, Yada T. Nesfatin-1 enhances glucose-induced insulin secretion by promo-ting Ca(2+) influx through L-type channels in mouse islet β-cells. Endocr J. 2011;58(4):305-313.
There are 24 citations in total.

Details

Primary Language English
Subjects Anaesthesiology
Journal Section Research Article
Authors

Ahmet Aksu 0000-0003-2689-528X

İsmail Demirel 0000-0002-9183-8225

Project Number TF 14.55
Submission Date December 10, 2024
Acceptance Date January 16, 2025
Early Pub Date August 1, 2025
Publication Date August 8, 2025
Published in Issue Year 2025 Volume: 9 Issue: 2

Cite

APA Aksu, A., & Demirel, İ. (2025). The Evaluation of Hemodynamic and Endocrine Response and Nesfatin-1 in Patients Undergoing Inhalation and Total Intravenous Anesthesia. Ahi Evran Medical Journal, 9(2), 142-152. https://doi.org/10.46332/aemj.1597215
AMA Aksu A, Demirel İ. The Evaluation of Hemodynamic and Endocrine Response and Nesfatin-1 in Patients Undergoing Inhalation and Total Intravenous Anesthesia. Ahi Evran Med J. August 2025;9(2):142-152. doi:10.46332/aemj.1597215
Chicago Aksu, Ahmet, and İsmail Demirel. “The Evaluation of Hemodynamic and Endocrine Response and Nesfatin-1 in Patients Undergoing Inhalation and Total Intravenous Anesthesia”. Ahi Evran Medical Journal 9, no. 2 (August 2025): 142-52. https://doi.org/10.46332/aemj.1597215.
EndNote Aksu A, Demirel İ (August 1, 2025) The Evaluation of Hemodynamic and Endocrine Response and Nesfatin-1 in Patients Undergoing Inhalation and Total Intravenous Anesthesia. Ahi Evran Medical Journal 9 2 142–152.
IEEE A. Aksu and İ. Demirel, “The Evaluation of Hemodynamic and Endocrine Response and Nesfatin-1 in Patients Undergoing Inhalation and Total Intravenous Anesthesia”, Ahi Evran Med J, vol. 9, no. 2, pp. 142–152, 2025, doi: 10.46332/aemj.1597215.
ISNAD Aksu, Ahmet - Demirel, İsmail. “The Evaluation of Hemodynamic and Endocrine Response and Nesfatin-1 in Patients Undergoing Inhalation and Total Intravenous Anesthesia”. Ahi Evran Medical Journal 9/2 (August2025), 142-152. https://doi.org/10.46332/aemj.1597215.
JAMA Aksu A, Demirel İ. The Evaluation of Hemodynamic and Endocrine Response and Nesfatin-1 in Patients Undergoing Inhalation and Total Intravenous Anesthesia. Ahi Evran Med J. 2025;9:142–152.
MLA Aksu, Ahmet and İsmail Demirel. “The Evaluation of Hemodynamic and Endocrine Response and Nesfatin-1 in Patients Undergoing Inhalation and Total Intravenous Anesthesia”. Ahi Evran Medical Journal, vol. 9, no. 2, 2025, pp. 142-5, doi:10.46332/aemj.1597215.
Vancouver Aksu A, Demirel İ. The Evaluation of Hemodynamic and Endocrine Response and Nesfatin-1 in Patients Undergoing Inhalation and Total Intravenous Anesthesia. Ahi Evran Med J. 2025;9(2):142-5.

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