Influence of epidural analgesia on postoperative changes in various serum enzyme patterns and serum bilirubin

Postoperative changes in serum bilirubin, various serum enzymes (alanine-amino transferase ALAT), alkaline phosphatase (AP), lactate-dehydrogenase (LDH), and creatine-phosphokinase (CPK)), plasma glucose and cortisol were studied in 20 healthy, premenopausal women undergoing elective abdominal hysterectomy under either general anaesthesia with halothane or epidural analgesia (T4-S5). Surgery under general anaesthesia was followed by increased levels of bilirubin, LDH, CPK, glucose and cortisol, whereas AP and ALAT were unaffected by surgery. Epidural analgesia inhibited increases in LDH, CPK, glucose and cortisol (P less than 0.05), but not the increase in bilirubin. The results indicate that afferent neurogenic stimuli from the surgical area are important in mediating the postoperative changes in LDH and CPK, whereas factors other than neurogenic stimuli or adrenal hormones are responsible for the postoperative changes in bilirubin.