ABSTRACT
The place of laparoscopic surgery continues to increase in the field of surgery in our specialty. Although the advantages would seem to be obvious, it seemed to us interesting to quantify, if possible, the parameters of operative stress and compare laparoscopic surgery with conventional surgery. Markers studied are Prolactin, Cortisol, Adrenaline, Nor-Adrenaline, Dopamine and the Beta-Endorphins. The only marker that shows any difference in the two procedures in our study is Beta-Endorphin which is significantly less raised in laparoscopic surgery directly after the operation (p less than 0.01). This was very specific for pain, which is one of the benefits of this technique and shown in this parameter which confirms the clinical impression. The curves of the changes in the different markers have been analysed and discussed.
Subject(s)
Biomarkers/blood , Intraoperative Complications/blood , Laparoscopy/adverse effects , Laparotomy/adverse effects , Stress, Physiological/blood , Adult , Body Weight , Dopamine/blood , Epinephrine/blood , Evaluation Studies as Topic , Female , Humans , Hydrocortisone/blood , Infertility, Female/surgery , Intraoperative Complications/epidemiology , Intraoperative Complications/etiology , Norepinephrine/blood , Ovarian Cysts/surgery , Prolactin/blood , Stress, Physiological/epidemiology , Stress, Physiological/etiology , Time Factors , beta-Endorphin/bloodABSTRACT
413 menstrual cycles were monitored in the first two years of the work of the In-Vitro Fertilization Unit in La Pitié-Salpêtrière. On-going pregnancies were achieved from the very first months of activity, with a level which stayed relatively constant in the first year. Technical changes were introduced and in particular a higher recovery rate of oocytes when ultrasound was used and above all when LH-RH analogues were used in the process of stimulation. It is this last point that seems to be the most interesting. In fact, when the results are examined there is a definite rise in the number of on-going pregnancies of which the level went up by 2.3 times as compared with using a classical protocol of Clomithene citrate and HMG. In the 153 cycles when D-Trp6 LH-RH was used, the percentage of on-going pregnancies was 13.7% for each cycle and 20% for embryo implants. Furthermore, it became possible to work out the dates for the patients and this appears to us essential as the numbers of couples attending increase.
