ABSTRACT
OBJECTIVES: To assess the relation between plasma levels of prolactin and spontaneous movements in children anesthetized with propofol and to compare the prolactin endocrine response for 2 different techniques of anesthetic maintenance. PATIENTS AND METHOD: This was a prospective study of 35 ASA I children between 4 and 11 years of age, with no history of epilepsy or febrile convulsions, who underwent herniorrhaphy or orchidopexy. The patients were not premedicated. Before induction they received 0.02 mg/kg atropine and 2.5 micrograms/kg i.v.; induction was with 4 mg/kg propofol and 0.5 mg/kg atracurium. For maintenance the sample was randomly divided into 2 groups. Group A (n = 18) received 10 mg/kg/h propofol and 40% O2/air. Group B (n = 17) received 1-0.7% isoflurane and 40% N2O/O2. We measured plasma levels of prolactin before induction (baseline prolactin) and after extubation (postoperative prolactin). We also assessed pain upon injection of propofol by observing and recording spontaneous movement. RESULTS: The number of children who remained in the study was 24, with 14 in group A and 10 in group B. We observed a significant increase (p < 0.05) of postoperative prolactin in children with spontaneous movement (15.3 +/- 7.5 vs. 87.1 +/- 42.9 ng/ml) as well as in those with no movement (23.8 +/- 15.9 vs. 82.4 +/- 29.7 ng/ml). There were no significant differences between baseline prolactin (20.9 +/- 16.9 vs. 21.8 +/- 10.8 ng/ml) and postoperative levels (90 +/- 35.4 vs. 75 +/- 29 ng/ml) related to technique. CONCLUSIONS: Increase in prolactin is unrelated to spontaneous movements, which are attributable to low induction dose. Differences in prolactin plasma levels are not related to anesthetic technique.
Subject(s)
Anesthesia, Intravenous/adverse effects , Anesthetics, Intravenous/adverse effects , Hyperprolactinemia/etiology , Propofol/adverse effects , Stress, Physiological/blood , Child , Child, Preschool , Convulsants/adverse effects , Cryptorchidism/surgery , Female , Hernia, Inguinal/surgery , Humans , Infusions, Intravenous/adverse effects , Male , Movement/drug effects , Pain/blood , Pain/etiology , Prolactin/blood , Prolactin/metabolism , Prospective Studies , Stress, Physiological/etiology , Stress, Physiological/physiopathologyABSTRACT
The high incidence of transient thyroid dysfunction in newborns from our hospital (0.6%), led us to investigate whether povidone perineal prep. during delivery and daily postpartum antisepsis, induced iodine overload in the newborn, and whether breast milk was the vehiccle. In a controlled randomized trial we used either povidone-iodine or clorhexidine in 36 mothers, and we investigated in them and in their newborns iodine levels and thyroid function. Iodine levels in cord blood, maternal urine and newborn urine were significantly higher in povidone treated group (p less than 0.001) up to the 4th postpartum day. These levels were also significantly higher in breast fed than in formula-fed babies within the group of povidone-iodine-treated mothers. Maternal prepartum urine iodine, and thyroid function in mothers and newborns were not significantly different in both groups.
