Compared with the control values (p<0.05)

## Compared in Group I post op. 1th and 24th hours values (p<0.05).

Fig. 2. Changes in Insulin values when compared to Groups

The postoperative cortisol values at 1 hour differed between the groups and were highest in Group III (p<0.05). The intra-group comparison of the cortisol values revealed higher measurements one hour after the operation relative to the control values (p<0.05). The 24th

The Effect of General Anesthesia and General Anesthesia Plus Epidural

P <0.05 <0.05 <0.05

effect of levobupivacaine compared to bupivacaine (5-8).

\*Comparisons between-groups (p<0.05) # Comparison intra-groups (p<0.05). Table 3. VAS values (Mean ± SD)

(p>0.05).

**4. Discussion** 

between the groups.

Levobupivacaine or Bupivacaine on Hemodynami Stress Response and Postoperative Pain 217

The comparison of the postoperative pain scores between the groups demonstrated the highest VAS value at minute 0 in Group III (p<0.000). Regarding the other measurement

GROUP I GROUP II GROUP III P

times, no significant difference was detected between the groups (p>0.05) (Table 3).

Postop 0th min. 0.38 ± 1.14 1.33 ± 2.02 5.88 ± 1.99 \* 0.000 Postop 30th min. 4.77 ± 1.95 # 4.50 ± 2.22 # 5.83 ± 1.75 0.172 Postop 2nd h 3.77 ± 2.21 # 3.22 ± 2.43 2.55 ± 1.72 # 0.388 Postop 6th h 2.11 ± 2.13 1.33 ± 1.74 1.33 ± 1.13 # 0.465 Postop 12th h 0.38 ± 0.69 0.50 ± 1.42 0.77 ± 1.16 # 0.325 Postop 24th h 0.25 ± 0.23 0.27 ± 0.75 0.33 ± 0.76 # 0.355

The comparison of the postoperative hemodynamic data revealed the highest MBP at minute 0 in Group III (p<0.002). None of the three groups exhibited postoperative hypotension or respiratory depression. Regarding the motor block, there was no significant difference between Groups I and II with respect to nausea-vomiting, itching, or tremor

In this trial investigating the extent of suppression of the stress response to surgery in patients undergoing general anesthesia + epidural anesthesia achieved with two different local anesthetics relative to the patients only receiving general anesthesia, the intraoperative hemodynamics, intraoperative anesthetic and analgesic agent requirement, the postoperative analgesia quality, the side effects and the recovery were also compared

Bupivacaine is commonly used in epidural analgesia owing to its long-lasting effect and the sensory block it achieves that is more marked than the motor block. However, levobupivacaine was reported to be safer with respect to the central nervous system toxicity and cardiotoxicity in addition to exhibiting a local anesthetic effect similar to bupivacaine in the clinical trials. The tendency for sensory block is longer with levobupivacaine relative to bupivacaine. Following epidural administration of levobupivacaine, the duration of the motor block was observed to be shorter than that of the sensory block. Levobupivacaine was reported to be as effective as bupivacaine when combined with morphine or fentanyl in the treatment of postoperative pain. Some trials demonstrated that levobupivacaine exhibited small increases in the sensory block time relative to bupivacaine, in line with the results from this trial. This finding may be attributed to the relatively increased vasoconstrictor

In this trial, there was no difference between Group I and Group II in the time to achieve sensory block at T6. There was no difference between the two groups in the motor block levels measured until the time to achieve sensory block at T6 dermatome. The follow-ups

hour postoperative cortisol values were higher than the control value only in Group III (p<0.05) (Figure 3).

\* Compared with the Groups (p<0.05)
