Email this article Effect of neuroaxial blockade on endocrine-metabolic and inflammatory response in abdominal surgery
- Authors: Luboshevsky P.A.1, Ovechkin A.M.2, Zabusov A.V.1
-
Affiliations:
- Yaroslavl State Medical Academy
- The I. M. Sechenov Moscow Medical Academy
- Issue: Vol 4, No 1 (2010)
- Pages: 13-17
- Section: Articles
- URL: https://bakhtiniada.ru/1993-6508/article/view/36054
- DOI: https://doi.org/10.17816/ра.v4i1.36054
- ID: 36054
Cite item
Full Text
Abstract
The aim of the study was to assess effect of different kind of neuroaxial blockade on endocrine-metabolic response as well as plasma concentration of pro- and anti-inflammatory cytokines in highly traumatic abdominal surgery. 60 patients who underwent elective abdominal surgery were included. The patients were classified into groups according to the type of surgery (upper or lower abdominal surgery) and way of anesthesia/analgesia (general anesthesia or general anesthesia combined with spinal/epidural one). Quality of postoperative analgesia, plasma concentration of glucose, cortisol and interleukins were measured. The results of our work indicate that using of neuroaxial anesthesia technique, namely epidural anesthesia/analgesia, allows of effective containing of surgical stress-response to promote reduction of postoperative complications.
Full Text
##article.viewOnOriginalSite##About the authors
P. A. Luboshevsky
Yaroslavl State Medical Academy
A. M. Ovechkin
The I. M. Sechenov Moscow Medical Academy
A. V. Zabusov
Yaroslavl State Medical Academy
References
- Ahlers O., Nachtigall I., Lenze J. et al. Intraoperative thoracic epidural anaesthesia attenuates stress-induced immunosuppression in patients undergoing major abdominal surgery // Br. J. Anaesth. 2008; 101(6): 781-787.
- Baigrie R. J., Lamont P M., Kwiatkowski D. et al. Systemic cytokine response after major surgery // Br. J. Surg. 1992; 79: 757-760.
- Choileain N. N., Redmond H. P Cell response to surgery // Arch Surg. 2006; 141: 1132-1140.
- Collier B., Dossett L. A., May A. K., Diaz J. J. Glucose control and the inflammatory response // Nutrition in Clinical Practice. 2008; 23(1): 3-15.
- Desborough J. P The stress response to trauma and surgery // Br. J. Anaesth. 2000; 85(1): 109-117.
- Esposito K., Nappo F., Marfella R. et al. Inflammatory cytokine concentrations are acutely increased by hyperglycemia in humans. Role of oxidative stress // Circulation. 2002; 106: 2067-2072.
- Hahnenkamp K., Theilmeier G., Van Aken H. K., Hoenemann C. W. The effects of local anesthetics on perioperative coagulation, inflammation, and microcirculation // Anesth. Analg. 2002; 94(6): 1441-1447.
- Marz P., Cheng J. G., Gadient R. A. et al. Sympathetic neurons can produce and respond to interleukin 6 // Proc. Natl. Acad. Sci. U S A. 1998; 95: 3251-3256.
- Volk T., Schenk M., Voigt K. et al. Postoperative epidural anesthesia preserves lymphocyte, but not monocyte, immune function after major spine surgery // Anesth. Analg. 2004; 98: 1086-1092.
- Webster J., Barnard M., Carli F. Metabolic response to colonic surgery: extradural vs continuous spinal // Br. J. Anaesth. 1991; 67(4): 467-469.
- Weekers F., Giulietti A. P., Michalaki M. et al. Metabolic, endocrine, and immune effects of stress hyperglycemia in a rabbit model of prolonged critical illness // Endocrinology. 2003; 144(12): 5329-5338.
Supplementary files
