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British Journal of Anaesthesia, 1987, Vol. 59, No. 6 725-729
© 1987 The Board of Management and Trustees of the British Journal of Anaesthesia

other

METABOLIC RESPONSE TO TOTAL HIP ARTHROPLASTY UNDER HYPOBARIC SUBARACHNOID OR GENERAL ANAESTHESIA

F. M. DAVIS, F.F.A.R.C.S., F.F.A.R.A.CS.*, V. G. LAURENSON, F.F.A.R.A.CS., J. LEWIS, PH.D., J. E. WELLS, PH.D. and W. J. GILLESPIE, CH.M., F.R.A.C.S., F.R.C.S.(ED.)

Christchurch Clinical School of the University of Otago Christchurch, New Zealand.

*Present address, for correspondence: Department of Anaesthesia, Christchurch Hospital, Christchurch, New Zealand.

Whole blood glucose concentration was estimated in 93 patients undergoing total hip arthroplasty under either subarachnoid or general anaesthesia. In 77, plasma cortisol concentration was also estimated before and after surgery. There were no preoperative differences between the two groups. Blood glucose concentration increased slightly following induction in both groups, but with spinal anaesthesia it decreased again, whereas with general anaesthesia it continued to increase (P < 0.0001). Plasma cortisol concentration with spinal anaesthesia was 291 (SD 145) nmol litre–1 before, and 279 (253) nmol litre–1 30 min after operation. With general anaesthesia there was a three-fold increase from 301 (159) nmol litre–1 (preoperative) to 987 (474) nmol litre–1 30 min after operation (P < 0.0001). Low spinal anaesthesia with a predominantly unilateral block appears sufficient to suppress the neuroendocrine response to hip surgery.


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