[ effect of opium addiction on response to major operation stress]

ABSTRACT

Internal medicine consultants are frequently asked to evaluate patients' tolerance against the stress of an intended surgical operation. Classification of surgical operations to mild, moderate and major is based on the morbidity and mortality rates due to the procedure, duration of procedure and underlying risk factors of the patient. Body response to surgical stress is via some hormonal alterations following the activation of hypothalamo pituarity adrenal axis [HPA] and hormonal changes reflect the degree of surgical stress. Due to high prevalence of addict patients operated in our surgery center and the established effect of opioid agents on HPA, this case - control study designed to detect the effect of chronic opioid usage on body response to major operation stress. Twenty six patients selected for laparatomy, thoracotomy or thyroidectomy in two equal and matched groups of opium - addict and nonaddict were studied for alterations in serum cortisol, CRP, Glucose and interleukin -6 immediately after the induction of anesthesia and 4 and 24 hours postoperatively. The obtained results were analyzed by t-test. Serum cortisol level of addict group 24 hours after operation [288 ng/dl] showed significant increase comparing to that of non-addict group [195 ng/dl]. The obtained result show more severe response of opium addicts to major surgery stress comparing to non addicts