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Comparative Effects of Epidural Morphine and Epidural Analgesia with Local Anesthetic on the Endocrine-metabolic Response to Surgery

  • P. Christensen
  • I. W. Møller
  • J. Rem
  • M. R. Brandt
  • H. Kehlet
Part of the Anaesthesiologie und Intensivmedizin Anaesthesiology and Intensive Care Medicine book series (A+I, volume 158)

Abstract

Previous studies have shown that afferent neurogenic stimuli from the surgical area are a major release mechanism of the endocrine-metabolic response to surgery [4]. Thus, neurogenic blockade by epidural analgesia with a local anesthetic is effective in inhibiting the stress response to lower abdominal surgery [3], but no studies are available comparing the influence of different analgesic techniques on the surgical stress response. This study summarizes the comparative effects of epidural morphine [2], preoperative application of epidural analgesia with a local anesthetic, posttraumatic application of epidural analgesia [5], and general anesthesia with systemically administered opiates on the adrenocortical and hyperglycemic response to surgery.

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References

  1. 1.
    Behar M, Olshwang D, Magora F, Davidson JT (1979) Epidural morphine in treatment of pain. Lancet 1: 527PubMedCrossRefGoogle Scholar
  2. 2.
    Christensen P, Brandt MR, Rem J, Kehlet H (1982) Influence of epidural morphine on the adrenocortical and hyperglycemic response to surgery. Br J Anaesth 54: 23PubMedCrossRefGoogle Scholar
  3. 3.
    Engquist A, Brandt MR, Fernandes A, Kehlet H (1977) The blocking effect of epidural analgesia on the adrenocortical and hyperglycemic response to surgery Acta Anaesthesiol Scand 21: 330Google Scholar
  4. 4.
    Kehlet H, Brandt MR, Rem J (1980) Role of neurogenic stimuli in mediating the endocrine-metabolic response to surgery. JPEN 4: 152CrossRefGoogle Scholar
  5. 5.
    Møller IW, Rem J, Brandt MR, Kehlet H (1982) The effect of posttraumatic epidural analgesia on the Cortisol and hyperglycemic response to surgery. Acta Anaesthesiol Scand 26: 56PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1984

Authors and Affiliations

  • P. Christensen
  • I. W. Møller
  • J. Rem
  • M. R. Brandt
  • H. Kehlet

There are no affiliations available

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