[Comparison of postoperative blood cortisol levels after neuroleptanalgesia and extradural anesthesia].
Postoperative plasma cortisol levels were measured in two series of surgical patients who had undergone a gynaecological operation, with respectively 17 and 16 subjects. Samples were drawn on D0 6pm, D1 8am, D2 8am and D3 8 am. A reference sample had been taken before the premedication on D0 at 8 am. The first series had been anaesthetised using a dextromoramidedroperidol type neuroleptanalgesia followed by postoperative analgesia by a noramidopyrine compound. The second series required epidural anaesthesia followed by postoperative analgesia by the injection of lidocaine at constant rate, interrupted between the last two samples. In the neuroleptanalgesia group: from a basal level of 470 nmol.l-1, plasma cortisol rose to 800 nmol.l-1 (p less than 0.01) on D0 at 6 pm to subsequently remain on a plateau between 500 and 550 nmol.l-1 (NS) within the normal physiological limits for the laboratory. In the epidural group, from a basal level of 420 nmol.l-1, plasma cortisol rose to 1000 nmol.l-1 (p less than 0.01) to return to basal levels only on D3: 450 nmol.l-1 (NS) with intermediate values of 700 and 630 nmol.l-1 (respectively: p less than 0.001 and p less than 0.05). Statistical comparison between the two groups showed that the increase in cortisol in the epidural group in relation to the other was significant throughout the period of administration of lidocaine at constant flow rate: p less than 0.05 on D0 at 6pm, D1 and D2. The results are discussed.
D000328:Adult; D000767:Anesthesia, Epidural; D004177:Dipyrone / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007044:Hysterectomy; D008012:Lidocaine / Q000627:therapeutic use; D008875:Middle Aged; D009458:Neuroleptanalgesia; D011184:Postoperative Period
D004177:Dipyrone; D008012:Lidocaine; D006854:Hydrocortisone
Comparaison de la cortisolémie post-opératoire après neuroleptanalgésie et anesthésie extra-durale.