May 23, 2012

Spinal-general anaesthesia decreases neuroendocrine stress response in laparoscopic cholecystectomy

The Journal of International Medical Research
P Calvo-SotoC Vásquez

Abstract

A randomized clinical study to compare the stress response to laparoscopic cholecystectomy during spinal-general anaesthesia and epidural- general anaesthesia. Women undergoing elective laparoscopic chole cystectomy were assigned to receive either spinal anaesthesia (SA group; n = 12) or epidural anaesthesia (EA group; n = 12), in addition to general anaesthesia. Plasma concentrations of cortisol, adrenocorticotrophic hormone (ACTH), noradrenaline, adrenaline and total catecholamines were measured pre- and intraoperatively. Intraoperative cortisol, noradrenaline and total catecholamine levels were significantly lower in the SA group compared with the EA group. When pre- and intraoperative values were compared, the SA group showed a decrease in adrenaline, noradrenaline and total catecholamine levels, and the EA group showed an increase in ACTH and noradrenaline levels. The type of regional anaesthesia significantly affected the stress response: spinal anaesthesia produced a more favourable endocrine response than epidural anaesthesia. Spinal-general anaesthesia may reduce postoperative morbidity in laparoscopic cholecystectomy.

Mentioned in this Paper

Biological Adaptation to Stress
Morbidity Aspects
Catecholamine [EPC]
Epilepsy, Generalized
Body Parts - Epidural
POMC wt Allele
Epidural Anesthesia
Neurosecretory Systems
Mental Suffering
Norepinephrine, (+, -)-Isomer

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