The Effects of Desflurane and Propofol on the Release of Thyroid Hormones in Euthyroid Patients Undergoing Elective Lumbar Discectomy.

OBJECTIVE In this study, we aimed to compare the effects of desflurane and propofol on the release of thyroid hormones in euthyroid patients undergoing single-level lumbar discectomy. METHODS The study group included 21-65-year-old American Society of Anesthesiology (ASA) I-II euthyroid 40 patients undergoing elective single-level lumbar discectomy. They were randomly divided into 2 groups (n=20). In the maintenance of anaesthesia, Group D received desflurane inhalational anaesthesia and remifentanil infusion, and Group P received propofol and remifentanil IV infusions. Four blood samples for the determination of plasma levels of free triiodothyronine (FT3), free thyroxine (FT4) and thyrotropin (TSH) were collected 5 min before and 60 min after the induction of anaesthesia and 60 min and 24 h after the surgery. RESULTS Plasma TSH levels in both groups reached the highest levels at the first postoperative hour and returned to the preoperative levels 24 hours after the surgery. Regarding plasma FT3 levels, there were no significant differences within and between groups. There were no significant differences in plasma FT4 levels within the patients of Group P, but in Group D, FT4 levels reached its peak in the first hour of anaesthesia induction and returned back to preoperative levels 24 hours postoperatively (p<0.05). CONCLUSION Further studies are needed to confirm our findings and evaluate patients with thyroid gland pathologies.

[1]  A. Lele,et al.  Severe hypothyroidism presenting as myxedema coma in the postoperative period in a patient taking sunitinib: case report and review of literature. , 2013, Journal of clinical anesthesia.

[2]  A. Siemiatkowski,et al.  Stress hormone response to various anaesthetic techniques during thyroidectomy. , 2012, Anaesthesiology intensive therapy.

[3]  V. V. Kumar,et al.  Subclinical hypothyroidism: A cause for delayed recovery from anaesthesia? , 2011, Indian journal of anaesthesia.

[4]  Ediba Celic-Spuzic Effect of anesthesia on the changes in the hormones levels during and after transvesical prostatectomy. , 2011, Medicinski arhiv.

[5]  V. Živaljević,et al.  Modern concepts of preoperative preparation of patients with thyroid gland disease. , 2011, Acta chirurgica Iugoslavica.

[6]  J. Joh,et al.  The effects of desflurane and sevoflurane on hepatic and renal functions after right hepatectomy in living donors * , 2010, Transplant international : official journal of the European Society for Organ Transplantation.

[7]  S. Van Uum,et al.  The effects of opioids and opioid analogs on animal and human endocrine systems. , 2010, Endocrine reviews.

[8]  Satyavani Vemparala,et al.  Computational studies on the interactions of inhalational anesthetics with proteins. , 2010, Accounts of chemical research.

[9]  Konstantinos Kalimeris,et al.  The differential impact of volatile and intravenous anaesthetics on stress response in the swine , 2010, Hormones.

[10]  S. Dubrey,et al.  High output heart failure. , 2009, QJM : monthly journal of the Association of Physicians.

[11]  S. Orfanos,et al.  Thyroid Function Changes and Cytokine Alterations following Major Surgery , 2007, Neuroimmunomodulation.

[12]  T. Saranteas,et al.  Perioperative thyroid hormone kinetics in patients undergoing major oral and maxillofacial operations. , 2007, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[13]  J. Boldt,et al.  Insignificant effect of desflurane-fentanyl-thiopental on hepatocellular integrity--a comparison with total intravenous anaesthesia using propofol-remifentanil. , 2005, European journal of anaesthesiology.

[14]  J. Lien,et al.  Reproducible hepatic dysfunction following separate anesthesia with sevoflurane and desflurane. , 2003, Chang Gung medical journal.

[15]  H. Schicha,et al.  The Influence of Various Anesthetics on the Release and Metabolism of Thyroid Hormones: Results of Two Clinical Studies , 1995, Anesthesia and analgesia.

[16]  J. T. Gunza,et al.  Postoperative elevation of serum transaminases following isoflurane anesthesia. , 1992, Journal of clinical anesthesia.

[17]  T. Chikenji,et al.  Anaesthesia, Not Surgical Stress, Induces Increases in Serum Concentrations of Reverse Triiodothyronine and Thyroxine during Surgery , 1990, Experimental and clinical endocrinology.

[18]  A. Grossman,et al.  STUDIES OF THE OPIATE CONTROL OF PROLACTIN, GH AND TSH , 1981, Clinical endocrinology.