Volatile Anesthetics for Combination with Epidural Anesthesia

  • H. Gerber
Conference paper
Part of the Anaesthesiologie und Intensivmedizin Anaesthesiology and Intensive Care Medicine book series (A+I, volume 185)


In recent years methods of regional anesthesia have been used to an increasing extent in combination with general anesthesia. Indications for additional (light) anesthesia are: 1) incomplete analgesia, as may occur with high epidural blockade, 2) the requirement of sufficient relaxation in abdominal surgery, and 3) to ensure proper ventilation in surgery affecting part of the respiratory muscles. In addition one can hardly expect a patient to tolerate prolonged surgery in rather uncomfortable positions. The advantages of high nerve blockade and its effect on the intra- and postoperative endocrine response of the body have been documented for some well-defined surgical procedures in the lower abdomen, but their general validity has been modified to some extent by more recent studies [1]. It is a proven fact, however, that waking up is faster and more pleasant for the patient than after general anesthesia alone, be it inhalational or intravenous anesthesia or a combination of both.


Spinal Anesthesia Regional Anesthesia Epidural Anesthesia Volatile Anesthetic Inhalational Anesthetic 
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  1. 1.
    Kehlet H (1982) The modifying effect of general and regional anesthesia on the endocrine-metabolic response to surgery. Reg Anesth [Suppl] 7: S38–S48Google Scholar
  2. 2.
    Scott DB (1982) Cardiovascular effects of lumbar epidural and spinal anesthesia. Reg Anesth 7: S21–S23Google Scholar
  3. 3.
    Stühmeier K-D, Stanton-Hicks M, Höck A, Arndt JO (1984) Blutvolumenverteilung während Periduralanaesthesie ( PDA) am Menschen. ( Abstract) Anaesthesist 33: 460Google Scholar
  4. 4.
    Pflug AE, Halter JB (1981) Effect of spinal anesthesia on adrenergic tone and the neuroendocrine responsdses to surgical stress in humans. Anesthesiology 55: 120–126PubMedCrossRefGoogle Scholar
  5. 5.
    Hotvedt R, Platou ES, Refsum H (1983) Electrophysiological effects of thoracic epidural analgesia in the dog heart in situ. Cardiovasc Res 17: 259–266PubMedCrossRefGoogle Scholar
  6. 6.
    Roizen MF, Horrigan RW, Frazer BM (1981) Anesthetic doses blocking adrenergic (stress) and cardiovascular responses to incision - MAC BAR. Anesthesiology 54: 390–398PubMedCrossRefGoogle Scholar
  7. 7.
    Lunn JJ, Rorie DK (1984) Halothane-induced changes in the release and disposition of norepinephrine at adrenergic nerve endings in dog saphenous vein. Anesthesiology 61: 377–384.PubMedCrossRefGoogle Scholar
  8. 8.
    Prys-Roberts C (1982) Cardiovascular effects of continuous intravenous anaesthesia compared with those of inhalational anaesthesia. Acta Anaesth Scand [Suppl] 75: 10–17CrossRefGoogle Scholar
  9. 9.
    Stephen GW, Lees MM, Scott DB (1969) Cardiovascular effects of epidural block combined with general anaesthesia. Br J Anaesth 41: 933–938PubMedCrossRefGoogle Scholar
  10. 10.
    Scott DB, Littlewood DG, Brummond GB, Buckley PF, BG Covino (1977) Modification of the circulatory effects of extradural block combined with general anaesthesia by the addition of adrenaline to lignocaine solutions. Br J Anaesth 49: 917–925PubMedCrossRefGoogle Scholar
  11. 11.
    Germann PAS, Roberts JG, Prys-Roberts C (1979) The combination of general anaesthesia and epidural block I: the effects of sequence of induction on haemodynamic variables and blood gas measurements in healthy patients. Anaesth Intensive Care 7: 229PubMedGoogle Scholar
  12. 12.
    Mainzer J (1979) Awareness, muscle relaxants and balanced anaesthesia. Can Anaesth Soc J 26: 386–391PubMedCrossRefGoogle Scholar
  13. 13.
    Crawford JS (1971) Awareness during operative obstetrics under general anaesthesia. Br J Anaesth 43: 179–182PubMedCrossRefGoogle Scholar
  14. 14.
    Naomi S, Walts LF, Moreland JR (1983) Patient awareness during nitrous oxide, oxygen, and halothane anesthesia. Anesth Analg 62: 239–240Google Scholar
  15. 15.
    Bristow MR (1984) The adrenergic nervous system in heart failure. N Engl J Med 311: 850–851PubMedCrossRefGoogle Scholar
  16. 16.
    Dagnino J, Prys-Roberts C (1984) Studies of anaesthesia in relation to hypertension. VI: cardiovascular responses to extradural blockade of treated and untreated hypertensive patients. Br J Anaesth 56: 1065–1073PubMedCrossRefGoogle Scholar

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© Springer-Verlag Berlin Heidelberg 1987

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  • H. Gerber

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