Effects of three different methods of anesthesia on the release of brain natriuretic peptid in patients with cardiac risk undergoing lower extremity surgery

Materials and methods: Sixty patients with risk of CAD scheduled to undergo lower extremity surgery were divided into 3 groups. Group G was administered general anesthesia followed by intravenous patient-controlled analgesia (I.V PCA) (n = 20). Group L was administered lumbar epidural anesthesia followed by lumbar epidural analgesia (n = 20). Group T was administered general anesthesia combined with intra and postoperative thoracal epidural analgesia as well as I.V PCA (n = 20). Visual analog scale pain scores, hemodynamics, plasma catecholamines, cardiac troponin I (cTnI), atrial natriuretic peptide (ANP), and BNP were measured preoperatively and measurements were extended to 90 min after skin incision, towards the end of surgery, and in the morning of day 1, 2, and 3 postoperation. The data were statistically compared using multiple comparison tests.