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British Journal of Anaesthesia, 1989, Vol. 63, No. 5 508-515
© 1989 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

HORMONAL AND METABOLIC RESPONSES TO CHOLECYSTECTOMY: COMPARISON OF EXTRADURAL SOMATOSTATIN AND DIAMORPHINE

J. P. DESBOROUGH, M.B., CH.B., F.F.A.R.C.S., S. A. EDLIN, M.B., CH.B., M.R.C.P., F.F.A.R.C.S., J. M. BURRIN, B.SC., PH.D., S. R. BLOOM, M.D., D.SC., F.R.C.P., M. MORGAN, M.B., B.S., F.F.A.R.C.S. and G. M. HALL, M.B., B.S., PH.D., F.I.BIOL., F.F.A.R.C.S.

Department of Anaesthetics, Hammersmith Hospital, Royal Postgraduate Medical School Du Cane Road, London W12 OHS.
Department of Endocrinology, Hammersmith Hospital, Royal Postgraduate Medical School Du Cane Road, London W12 OHS.

We have studied the metabolic and hormonal responses to surgery, and the pain scores and analgesic requirements in 24 patients undergoing cholecystectomy, allocated randomly to three groups to receive either general anaesthesia alone, or general anaesthesia with extradural diamorphine 0.1 mg kg–1, or general anaesthesia with extradural somatostatin to a total dose of somatostatin 3 mg. The only significant effect of extradural diamorphine was a decrease in the glucose response to surgery. Somatostatin 3 mg by the extradural route caused a significant increase in the concentration of circulating somatostatin which resulted in a significant decrease in plasma growth hormone and insulin after 60 min of surgery, together with an increase in plasma glycerol concentration. Patients in the diamorphine group required significantly less i.v. analgesia in the postoperative period than the other two groups. Intraoperative somatostatin failed to provide any postoperative analgesia.


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