Spinal-general anaesthesia decreases neuroendocrine stress response in laparoscopic cholecystectomy.
J Int Med Res. 2012;40(2):657-65
Authors: Calvo-Soto P, Martínez-Contreras A, -Hernández BT, And FP, Vásquez C
OBJECTIVE: A randomized clinical study to compare the stress response to laparoscopic cholecystectomy during spinal-general anaesthesia and epidural- general anaesthesia.
METHODS: Women undergoing elective laparoscopic chole cystectomy were assigned to receive either spinal anaesthesia (SA group; n = 12) or epidural anaesthesia (EA group; n = 12), in addition to general anaesthesia. Plasma concentrations of cortisol, adrenocorticotrophic hormone (ACTH), noradrenaline, adrenaline and total catecholamines were measured pre- and intraoperatively.
RESULTS: Intraoperative cortisol, noradrenaline and total catecholamine levels were significantly lower in the SA group compared with the EA group. When pre- and intraoperative values were compared, the SA group showed a decrease in adrenaline, noradrenaline and total catecholamine levels, and the EA group showed an increase in ACTH and noradrenaline levels.
CONCLUSIONS: The type of regional anaesthesia significantly affected the stress response: spinal anaesthesia produced a more favourable endocrine response than epidural anaesthesia. Spinal-general anaesthesia may reduce postoperative morbidity in laparoscopic cholecystectomy.
PMID: 22613427 [PubMed – indexed for MEDLINE]