85547
document
Effect of extradural analgesia on stress responses to abdominal surgery in infants . We studied 40 children younger than 4 yr having elective abdominal surgery under general anaesthesia supplemented with either systemic opioids or extradural bupivacaine . Venous blood samples were obtained before tracheal intubation to measure baseline concentrations of adrenaline , noradrenaline , glucose , ACTH and cortisol . Additional samples were obtained 45 min after the start of surgery , at the end of surgery , 1 h and 24 h after the end of surgery . Plasma concentrations of bupivacaine were measured also in the extradural group at each sampling time . Both techniques provided acceptable analgesia , but the perioperative increases in adrenaline , glucose and ACTH were significantly greater in the opioid group . Noradrenaline concentrations decreased to less than baseline values in the extradural group and were significantly less than in the opioid group . The perioperative increase in cortisol was similar in the two groups , despite the differences in ACTH responses . Most responses returned to the baseline values within 24 h. Plasma bupivacaine concentrations remained within safe limits during the study , but systemic concentrations increased in some of the patients during postoperative infusion with 0.125 % bupivacaine .
85548
Intervention_Pharmacological
extradural analgesia
85549
Intervention_Pharmacological
general anaesthesia
85550
Intervention_Pharmacological
systemic opioids or extradural bupivacaine .
85551
Intervention_Pharmacological
bupivacaine
85552
Intervention_Pharmacological
bupivacaine
85553
Outcome_Physical
stress responses
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Outcome_Physical
Venous blood samples
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Outcome_Physical
concentrations of adrenaline , noradrenaline , glucose , ACTH and cortisol .
85556
Outcome_Other
Plasma concentrations of bupivacaine
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Outcome_Physical
perioperative increases in adrenaline , glucose and ACTH
85558
Outcome_Physical
Noradrenaline concentrations
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Outcome_Physical
perioperative increase in cortisol
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Outcome_Physical
Plasma bupivacaine concentrations
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Outcome_Physical
systemic concentrations
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Participant_Condition
infants .