British Journal of Anaesthesia, Vol 75, Issue 4 387-393, Copyright © 1995 by The Board of Management and Trustees of the British Journal of Anaesthesia
C. M. Moore, M. H. Cross, J. P. Desborough, J. M. Burrin, I. A. Macdonald and G. M. Hall
We have investigated the hormonal and metabolic effects of thoracic
extradural analgesia with bupivacaine in addition to sufentanil 20
micrograms kg-1 in nine patients undergoing coronary artery bypass surgery.
A control group received general anaesthesia alone. The catecholamine
response was inhibited for 24 h after surgery in patients who had received
extradural analgesia, and the cortisol response was suppressed during
cardiopulmonary bypass. Blood glucose values were unchanged until 24 h
after surgery in the extradural group. There were no significant
differences in cardiac index between the two groups of patients, although
heart rate and mean arterial pressure decreased before surgery in patients
who received extradural analgesia. The benefits of this technique in terms
of a reduction in postoperative morbidity remain to be determined.
CLINICAL INVESTIGATIONS
Hormonal effects of thoracic extradural analgesia for cardiac surgery
Department of Anaesthetics, Royal Postgraduate Medical School and Hammersmith Hospital, London W12 0HS
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