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Related Experiment Videos

Postoperative glucose tolerance during extradural analgesia

F P Buckley, H Kehlet, N S Brown

    British Journal of Anaesthesia
    |March 1, 1982
    PubMed
    Summary

    Extradural analgesia effectively manages surgical pain and blocks the immediate stress response in gynecological surgery patients. However, it does not fully prevent later cortisol release or improve glucose tolerance post-operation.

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    Area of Science:

    • Anesthesiology
    • Endocrinology
    • Surgical Medicine

    Background:

    • Gynecological surgery often involves significant postoperative pain and stress responses.
    • General anesthesia alone may not fully attenuate the metabolic and hormonal effects of surgery.

    Purpose of the Study:

    • To investigate the impact of extradural analgesia on the glycemic and hormonal responses to lower abdominal gynecological surgery.
    • To compare the effects of general anesthesia with and without extradural analgesia on glucose tolerance and stress hormone levels.

    Main Methods:

    • Thirteen patients undergoing gynecological surgery were divided into two groups: general anesthesia or general anesthesia plus extradural analgesia (T8-S5).
    • Intravenous glucose tolerance tests were conducted before surgery and 8 hours post-incision.

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  • Postoperative pain, cortisol, and insulin responses were assessed.

    • Main Results:

    • Extradural analgesia provided complete pain relief in all patients.
    • It effectively blocked the acute hyperglycemic response to surgery but not the late cortisol response.
    • Glucose tolerance and insulin response impairment after surgery were not significantly influenced by extradural analgesia.

    Conclusions:

    • Extradural analgesia is highly effective for postoperative pain control in gynecological surgery.
    • While it mitigates the immediate surgical stress response, its effect on late hormonal changes and glucose metabolism requires further investigation.
    • Potential mechanisms for unmitigated metabolic changes include incomplete sympathetic blockade or insufficient cortisol/catecholamine inhibition.