Comparative Effects of Epidural Morphine and Epidural Analgesia with Local Anesthetic on the Endocrine-metabolic Response to Surgery
Previous studies have shown that afferent neurogenic stimuli from the surgical area are a major release mechanism of the endocrine-metabolic response to surgery . Thus, neurogenic blockade by epidural analgesia with a local anesthetic is effective in inhibiting the stress response to lower abdominal surgery , 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 , preoperative application of epidural analgesia with a local anesthetic, posttraumatic application of epidural analgesia , and general anesthesia with systemically administered opiates on the adrenocortical and hyperglycemic response to surgery.
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