Influence of epidural blockade on postoperative plasma fibronectin concentrations

To investigate the influence of neurogenic and hormonal stimuli during and after surgery on plasma fibronectin levels, 16 females undergoing cholecystectomy were studied. Eight patients received general anaesthesia, and eight also received a thoracic epidural block with local anaesthetic, which was maintained for 24 h postoperatively. The epidural group had significantly lower plasma levels of adrenaline and cortisol than the general anaesthesia group in the postoperative period. The previously well-documented early decrease in plasma fibronectin concentration following surgery was observed, and was essentially parallel with that of albumin, pre-albumin and thyroid hormones, with no differences between the groups. However, the restoration of the fibronectin level was slower in the epidural group, with significantly lower values as compared with controls at 48 and 72 h after surgery (p less than 0.01-0.001). It was concluded that the post-traumatic plasma fibronectin decrease is not mediated by neurogenic or adrenal stimuli. Such stimuli may, however, influence the subsequent restoration of the plasma fibronectin concentration.