[Thoracic peridural anesthesia for intra- and postoperative analgesia in lung resections. A comparison of stress reactions and postoperative lung function].
47 patients who were scheduled for lung resection were assigned to two groups. 23 patients had a neurolept analgesia and postoperatively parenteral analgetics. 24 patients received a combination of thoracic peridural anaesthesia and nitrous oxide-oxygen anaesthesia for surgery. The peridural analgesia was continued for 2-3 days for postoperative pain control. Heart rate and mean arterial pressure were recorded. Before, during and after surgery blood was drawn for determination of plasma glucose and cortisol. Postoperatively vital capacity and FEV1 were measured and blood gas analyses were performed for one week. The combination of peridural and intubation anaesthesia resulted in very stable haemodynamics in comparison with the neurolept analgesia. Heart rate and mean arterial pressure decreased during surgery without peak levels as response to the surgical trauma. Blood glucose and plasma cortisol showed equal responses in both investigation groups. A reduced stress response by means of the peridural anaesthesia could not be demonstrated. During the first 48 h after surgery a significantly higher vital capacity was measured in the patients with peridural anaesthesia. FEV1 was analogously increased, the quotient of FEV1/VC was similar in both study groups. No obstruction was observed. PaO2 and paCO2 showed no clinically relevant differences. During surgery the combination of general and regional anaesthesia results in a lower stress response of the heart and postoperatively it improves lung function which is an important advantage in comparison with systemic analgetics.
D000328:Adult; D000368:Aged; D000767:Anesthesia, Epidural; D001784:Blood Gas Analysis; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000187:drug effects; D002045:Bupivacaine; D005260:Female; D005283:Fentanyl; D005541:Forced Expiratory Volume; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D009458:Neuroleptanalgesia; D010149:Postoperative Pain / Q000188:drug therapy*; D010197:Pancuronium; D011013:Pneumonectomy; D011184:Postoperative Period; D013312:Stress, Physiological / Q000209:etiology* / Q000503:physiopathology; D014797:Vital Capacity
D001786:Blood Glucose; D010197:Pancuronium; D005283:Fentanyl; D006854:Hydrocortisone; D002045:Bupivacaine
Die thorakale Periduralanaesthesie zur intra- und postoperativen Analgesie bei Lungenresektionen.