Epidural analgesia and the metabolic response to surgery.
The effect of epidural blockade on the metabolic and hormonal responses to pelvic surgery was investigated in 14 female patients. Central venous blood samples were collected every 30 minutes and analysed for free fatty acids, glycerol, beta-hydroxybutyrate, acetoacetate, glucose, lactate, pyruvate, cortisol and growth hormone concentrations. There was no change in fat and glucose metabolism except for a transient decrease in lipolysis after 30 minutes of surgery. Cortisol and growth hormone values were significantly increased (p less than 0.01) after 60 minutes. A small but statistically significant increase in blood lactate concentration was observed (p less than 0.01) and the concept of a "metabolic V/Q" abnormality is postulated to explain the lacticacidaemia.
D000328:Adult; D000698:Analgesia / Q000379:methods*; D000758:Anesthesia; D001786:Blood Glucose / Q000378:metabolism; D002045:Bupivacaine; D004824:Epidural Space; D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D013006:Growth Hormone / Q000097:blood; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007267:Injections; D007773:Lactates / Q000097:blood; D008055:Lipids / Q000097:blood; D008660:Metabolism; D009609:Nitrous Oxide; D010100:Oxygen; D011773:Pyruvates / Q000097:blood; D013514:Surgical Procedures, Operative
D001786:Blood Glucose; D007773:Lactates; D008055:Lipids; D011773:Pyruvates; D013006:Growth Hormone; D009609:Nitrous Oxide; D010100:Oxygen; D006854:Hydrocortisone; D002045:Bupivacaine