[Effects of bupivacain infiltration on insulin, glucose, prolactin and cortisol responses to operative stress after unilateral inguinal hernoiraphy among 3-7 year-old children]

Operative stress and post-operative pain are important issues in medicine. After any types of surgery, the stress hormones release responding to pain. In this study we applied Bupivacain infiltration in surgical wounds of inguinal hernia amongst children aged 3-7 years and evaluated its effects on some stress hormones and plasma levels of glucose. In this prospective study, 116 children aged 3-7 years [24 females, 92 males] undergone unilateral repair of inguinal hernia under general anesthesia at Mofid children hospital during 2005-2007, were devided into 2 groups. Perincisional wound infiltration of 1-2 mg/kg of Bupivacain was performed in experimental group. In both groups, 10-15 mg/kg of Acetaminophen suppository were recommended at the recovery room. 4 ml of blood samples were obtained at three distinct stages [preincisional stage, at the end of operation and 4 hours after operation] to measure the insulin, prolactin cortisol and glucose plasma levels of subjects. Post operative pain was measured objectively by Hannalla scale. In both groups plasma prolactin levels increased at the end of operation along with insulin, cortisol and glucose. However, these differences became statistically significant just for insulin. There were no significant differences between other variables. In addition, although the plasma concentration of above mentioned variables became lesser in the 4[th] hour of postoperative period in experimental group, there were no statistically significant difference compared to those of control group. Wound infiltration of Bupivacain decreases the stress hormones and pain during the post-operative period. We recommend this type of infiltration applying long-acting anesthetic agents with fewer numbers of side-effects