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

(Figure 2).

Fig. 1. Changes in Glucose values when compared to Groups

Levobupivacaine or Bupivacaine on Hemodynami Stress Response and Postoperative Pain 215

There was no statistically significant difference between the groups in the 1st and 24th hour measurements of the insulin values (p>0.05). In Group I, the postoperative 1st and 24th hour values were different and the 24th hour values were higher (p<0.05). In Group III, the postoperative values in the first and 24th hours were higher than the control values (p<0.05)

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


\* p< 0.05 Compared with Group I and Group II

(Mean ± SD)

Table 2. Mean doses of drugs used in the operation and recovery times.

There was no statistically significant difference between the groups with respect to requirement for atropine and ephedrine (p>0.05). One, two and nine patients received additional muscle relaxant administration in Group I, II and III respectively. There was a statistically significant difference between the groups with respect to the requirement of muscle relaxant (p=0.002), which was higher in Group III relative to Groups I and II.

Regarding the MBP values, Group III had the highest values at 5, 10, 15, 30, 45 and 60 minutes of incision and after extubation (p<0.05).

The intra-group MBP values showed significant reductions relative to the control values during induction, 2, 5 minutes after intubation and 2, 5, 10, 15, 30, 45, 60 and 90 minutes after the surgical incision in Group 1; during induction, five minutes after the intubation, and 2, 5, 10, 15, 30, 45 and 60 minutes after the surgical incision in Group II; and during induction, 2, 5 minutes after the intubation and 2, 30 and 45 minutes after the surgical incision in Group 3 (p<0.05). While there was no statistically significant difference between the post-extubation MBP values and the control MBP values in Groups I and II (p>0.05), Group III exhibited a significant increase relative to the control value in Group III (p<0.013).

The HBR values were lower in Group III compared to Groups I and II in the 2nd and 5th minutes of intubation (p<0.05).

The intra-group HBR values showed significant reductions relative to the control values during induction, and 2, 5, 10, 15, 30, 45 and 60 minutes after the surgical incision in Group I; during induction, and 10, 15, 30, 45 and 60 minutes after the surgical incision in Group II; and during induction, five minutes after intubation, and 2, 5, 10, 45 and 60 minutes after the surgical incision in Group III (p<0.05).

Since the duration of surgery was below 100 minutes in all patients, there was no requirement for additional epidural local anesthetic administration and the follow-ups at 120 minutes could not be conducted (Table 1).

The mean control values for the parameters used to assess the response to surgical stress including glucose, insulin, cortisol and the CRP values were statistically similar between the three groups (p>0.05).

While the postoperative glucose values in the first and 24th hours were not significantly different, they were higher in Group III relative to Groups I and II (p>0.05). Regarding the intra-group comparison, the glucose values exhibited a significant increase relative to the control values one hour after the operation in all groups, and 24 hours after the operation in Groups I and III (p<0.05) (Figure 1).
