[Effects of continuous epidural infusion of local anesthetics on endocrine-metabolic responses to hysterectomy]

Abstract

The plasma concentrations of glucose, insulin, epinephrine, norepinephrine and cortisol were measured in 18 women before, during and after abdominal hysterectomy. Nine patients received continuous epidural analgesia with intermittent injections of 10 ml of mepivacaine solution (intermittent group), and 9 others received epidural analgesia with continuous infusion of 10 ml.h-1 of 2% mepivacaine (continuous group). Plasma glucose and insulin concentrations remained unchanged during and after surgery in the two groups. Plasma epinephrine and norepinephrine concentrations increased after surgery, and cortisol concentration increased during and after surgery in the two groups. Plasma concentration of glucose during surgery was significantly lower in the continuous group than in the intermittent group. The methods of epidural administration of local anesthetics exert little influence on endocrine-metabolic responses to stress associated with lower abdominal surgery.