Inhibition of adrenergic response to upper abdominal surgery with prolonged epidural blockade

The influence of prolonged epidural blockade on urinary excretion of epinephrine and norepinephrine was studied in 34 patients prepared for elective gastrectomy. The patients operated on under general anesthesia showed a remarkable increase in excretion of epinephrine and norepinephrine on the day of operation, and a continued increase of norepinephrine excretion of 2 days postoperatively. These adrenergic responses were significantly inhibited in the patients undergoing gastrectomy and epidural blockade extending from T3-4 to L1-2 and continuing for 48 hours postoperatively. Thus, the sympathetic hyperactivity due to upper abdominal operation may be reduced by prolonged epidural blockade with no apparent deleterious effects.