Background. Pain aggravates the autonomic response to stress and raises neuroendocrine stress hormone levels. We compared the effects of propofol and sevoflurane on postoperative pain and neuroendocrine stress hormones. A prospective, randomized, and controlled trial was conducted with 60 patients. Methods. We randomly allocated patients to groups P (remifentanil/propofol, n = 30) and S (remifentanil/sevoflurane, n = 30). Preoperative blood samples were taken to measure serum adrenocorticotropic hormone (ACTH), corticotropin-releasing hormone (CRH), glucagon, cortisol, aldosterone, and prostaglandin E2 (PGE2) levels. Intraoperatively and postoperatively, clinical parameters were monitored at different time points. The hormone levels were again measured in the follicular fluid and blood postoperatively. Result. Demographic data were similar. The preoperative serum aldosterone levels were significantly higher in group P (). Preoperative and postoperative serum ACTH, glucagon, cortisol, and PGE2 levels were significantly different in group P (, , , and ); serum ACTH, glucagon, and PGE2 levels increased while serum cortisol levels decreased postoperatively. In group S, serum CRH and aldosterone levels, both increased in the postoperative period compared to the preoperative (, ). Postoperatively, glucagon and PGE2 levels were both higher in group P than group S (, ). In postoperative follicular fluid, glucagon and PGE2 levels were higher in group P, while cortisol levels were higher in group S (, , and ). Conclusion. The effects of anesthetic agents were different. In group P, in the preoperative and postoperative evaluation, ACTH, glucagon, and PGE2 increased postoperatively, while cortisol decreased. In group S, aldosterone and CRH increased postoperatively. Glucagon and PG E2 were higher in group P than S, postoperatively.

中文翻译：

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异丙酚与七氟醚对卵母细胞拾取患者术后疼痛和神经内分泌应激反应的影响

背景。疼痛加剧了对压力的自主反应，并提高了神经内分泌压力激素水平。我们比较了异丙酚和七氟醚对术后疼痛和神经内分泌应激激素的影响。对60例患者进行了一项前瞻性，随机对照研究。方法。我们将患者随机分为P组（瑞芬太尼/丙泊酚，n  = 30）和S组（瑞芬太尼/七氟醚，n = 30）。术前采集血样以测量血清促肾上腺皮质激素（ACTH），促肾上腺皮质激素释放激素（CRH），胰高血糖素，皮质醇，醛固酮和前列腺素E2（PGE2）的水平。术中和术后，在不同时间点监测临床参数。术后再次测量卵泡液和血液中的激素水平。结果。人口统计数据相似。P组术前血清醛固酮水平明显升高（P <0.05）。）。P组术前和术后血清ACTH，胰高血糖素，皮质醇和PGE2水平显着不同（， ， ，和）; 术后血清ACTH，胰高血糖素和PGE2水平升高，而血清皮质醇水平降低。与手术前相比，S组患者的血清CRH和醛固酮水平在术后期间均升高（， ）。术后P组的胰高血糖素和PGE2水平均高于S组（， ）。在术后卵泡液中，P组的胰高血糖素和PGE2水平较高，而S组的皮质醇水平较高（， ，和）。 结论。麻醉剂的作用不同。P组在术前和术后评估中，术后ACTH，胰高血糖素和PGE2升高，而皮质醇降低。在S组中，醛固酮和CRH在术后增加。术后胰高血糖素和PG E2在P组高于S组。