Halothane–Morphine Compared with High-Dose Sufentanil for Anesthesia and Postoperative Analgesia in Neonatal Cardiac Surgery

OPIOID anesthetic agents in high doses can blunt endocrine and metabolic responses to cardiac or noncardiac operations in adults, as demonstrated by perioperative changes in the levels of cortisol, 1 , 2 catecholamines, 3 vasopressin, 4 and growth hormone. 1 These drugs may also reduce the mobilization of metabolic substrates that follows stimulation of glycogenolysis, gluconeogenesis, lipolysis, and protein breakdown. 2 , 3 Deeper levels of opioid anesthesia produce a dose-dependent inhibition of responses to the stress of surgery; such effects may be due to central or peripheral neuroendocrine regulatory mechanisms or may be the direct effects of opioids on endocrine glands. 5 The metabolic balance of neonates is precarious, . . .