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document
[ The effect of thoracic peridural analgesia on the cortisol and glucose response in surgery of the abdominal aorta ] . UNLABELLED It has been shown that the stress response to lower abdominal surgery can be inhibited by epidural analgesia ( EA ) . But EA seems to have little influence on the stress reaction to major abdominal surgery . The purpose of our study was to find out whether EA is able to diminish the cortisol and glucose response to major transabdominal surgery . METHODS 31 patients undergoing elective surgery of the abdominal aorta were subdivided at random into 3 different anaesthesia groups : 1. halothane anesthesia , 2. neuroleptanalgesia ( NLA ) and 3. thoracic EA with bupivacaine ( 0.5 % ) in combination with a light general anesthesia . Some patients of each group received an intravenous infusion of 5 % glucose . Blood samples were drawn before anesthesia , after intubation , 5 times during surgery and at the end of the operation and were analysed for cortisol and glucose . During the early postoperative period , 1 , 2 and 24 h after surgery , only cortisol was measured . RESULTS Only the glucose levels of patients who received no carbohydrate-containing infusion fluids were used for evaluation of the stress response . In the halothane group , there was a significant increase of the mean cortisol and glucose levels after the start of surgery . No intraoperative elevations of blood glucose and cortisol were seen in the EA group . Patients of the NLA group showed no hyperglycaemia and only mild elevations of the cortisol levels during the intraoperative period . ( ABSTRACT TRUNCATED AT 250 WORDS )
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Intervention_Pharmacological
thoracic peridural analgesia
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Intervention_Pharmacological
epidural analgesia ( EA )
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Intervention_Pharmacological
halothane anesthesia
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Intervention_Pharmacological
neuroleptanalgesia ( NLA )
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Intervention_Pharmacological
thoracic EA with bupivacaine ( 0.5 % )
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Intervention_Control
general anesthesia
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Outcome_Physical
cortisol and glucose response
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Outcome_Mental
cortisol and glucose response
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Outcome_Mental
cortisol
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Outcome_Physical
glucose levels
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Outcome_Physical
mean cortisol
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Outcome_Physical
glucose levels
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Outcome_Physical
blood glucose
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Outcome_Physical
cortisol