SOMATOSTATIN AND TOTAL INTRAVENOUS ANESTHESIA - ASSESSMENT OF ANALGESIC REQUIREMENTS DURING SURGERY AND THE EFFECTS ON LIVER ENZYMES

We have studied the analgesic effects of somatostatin during surgery a nd its influence on the plasma glucose levels and the liver enzyme pro file in 40 ASA 1 or 2 patients undergoing surgery for carcinoma of the gastrointestinal tract. Each patient received either somatostatin bol us 3.5 mu g.kg(-1) intravenously plus an infusion of somatostatin 3.5 mu g.kg(-1).h(-1), or sodium chloride 0.9% as a placebo in a double-bl ind manner. Anaesthesia was induced with propofol 1 mg.kg(-1) followed by a continuous infusion of propofol in a stepwise declining regimen. Vecuronium was used for muscular relaxation. Fentanyl 100 mu g was ad ministered intravenously in bolus doses for analgesia during surgery a s required. Blood samples were taken at 10 min pre-induction, 5 min po stintubation, 5, 30, 60, 120 min postincision and 30 min post-recovery for plasma glucose levels. Blood samples were also taken at 10 min pr e-induction, 120 min postincision and 24 h postoperatively for liver e nzymes. The total requirement for fentanyl in the control group was si gnificantly higher (p < 0.001) than in the group that received somatos tatin. Eight out of 20 patients in the study group required no additio nal analgesia intra-operatively. The changes in blood glucose values f ollowed the same pattern in both groups. There was a tendency for live r enzymes to increase in both groups. Although this increase was less in the study group, this change was not statistically significant.