THE METABOLIC AND HORMONAL EFFECTS OF PERIOPERATIVE IBUPROFEN - TREATMENT ON THE SURGICAL STRESSÖnder Aydın1, Mustafa Aldemir2, İbrahim Taçyıldız1, Sadullah Girgin1, Tahir Şen1, Bilsel Baç11Dicle Üniversitesi Tıp Fakültesi Genel Cerrahi Anabilim Dalı, 20280, Diyarbakır, Turkey 2Dicle Üniversitesi Tıp Fakültesi Genel Cerrahi Anabilim Dalı, 20280, Diyarbakır, Turkey, Maldemir21@Hotmail.Com
BACKGROUND: Surgical stress induces hormonal and cytokine responses proportional to the extent of the injury. Perioperative administration of cyclo-oxygenase inhibitors reduces cytokine production and nitrogen losses. The objective of this study is to evaluate clinically the metabolic and hormonal effects of ibuprofen which is cyclooxigenase inhibitor on surgical stress. METHODS: A prospective clinic study was performed in 20 patients who undergone thyroidectomy. Patients were randomly divided I two groups as ibuprofen group (n= 10) and control group (n= 10). In the ibuprofen group, pills containing ibuprofen (400 mg) were administered orally 12 and 2 hours before surgery, and every 8 hours until the third postoperative day. In the both groups, blood samples were collected 24 and 2 hours before surgery and I, 4, 6, 24, 48, and 72 hours after skin incision for glucose, CRp; leukocytes, ACTH, cortisol determinations. RESULTS: When preoperative values were compared with postoperative values, surgical stress caused significantly changes on the all parameters in the both groups. The highest levels of ACTH and cortisol were at 1st and 6th hours respectively. In both groups, plasma cortisol levels remained elevatedfor 3 days, whereas plasma ACTH levels returned to the basal level at 1 day. In the ibuprofen group, the levels of ACTH and cortisol were significantly less than those of control group (p < 0.00 1 and p < 0.00 1). In the ibuprofen group glucose level (p< 0.00 1) and count leukocyte (p< 0.00 1) increased mildly. The level of CRP increased gradually after first day and were high until 3th days (p < o. 0 1). In the ibuprofen group the fever increased smaller (p < O. 0 1). CONCLUSION: In conclusion, in perioperative period pretreatment with ibuprofen is able to reduce the neuroendocrine and humoral responses, but it can not completely suppress. Our present study suggests that ibuprofen may be useful in decreasing the surgical stress response in the serious patients.
PERİFOPERATİF İBUPROFEN TEDAVİSİNİN CERRAHİ STRES ÜZERİNDEKİ HORMONAL VE METABOLİK ETKİLERİÖnder Aydın1, Mustafa Aldemir2, İbrahim Taçyıldız1, Sadullah Girgin1, Tahir Şen1, Bilsel Baç11Dicle Üniversitesi Tıp Fakültesi Genel Cerrahi Anabilim Dalı, 20280, Diyarbakır, Turkey 2Dicle Üniversitesi Tıp Fakültesi Genel Cerrahi Anabilim Dalı, 20280, Diyarbakır, Turkey, Maldemir21@Hotmail.Com
Önder Aydın, Mustafa Aldemir, İbrahim Taçyıldız, Sadullah Girgin, Tahir Şen, Bilsel Baç. THE METABOLIC AND HORMONAL EFFECTS OF PERIOPERATIVE IBUPROFEN - TREATMENT ON THE SURGICAL STRESS. Ulus Travma Acil Cerrahi Derg. 2002; 8(1): 6-10 |
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