Abstract:

To observe the influences of different approaches on stress reaction upon general anesthesia, thirty-one patients ASA grade Ⅰ-Ⅱ, scheduled for selective neurosurgery, were allocated into two groups according to transsphenoidal approach and transcranial approach. Group S(n=16)underwent transsphenoidal approach and group F(n=15)did transcranial approach. Observing points were made at inducting(T1), intubating(T2), placing Hardy-Cushing′s Scope(T3), and destroying the bone of bottom sella(T4)in group S; and at inducting(T1), intubating(T2), peeling off periosteum(T3), sawing skull(T4)in group F. Plasma glucose, serum insulin and glucagon were measured. The value of mean arterial pressure and heart rate were recorded. ln group S,MAP and GLA decreased significantly at the period of T2; and HR, GLU, GLA changed significantly at the period of T3(P<0.01); MAP and INS, and GLA significantly decreased and GLU increased significantly at the period of T4. In group F, MAP and GLA decreased significantly at the period of T2; GLU increased and GLA decreased at the period of T3; HR and GLU increased significantly, and INS decreased significantly at the period of T4(P< 0.01). There are no significant changes in hemodynamics and glycometabolism undergoing transsphenoidal approach and transcranial approach.

Key words: pituitary adenoma, stress reaction, anesthesia