Favorable Effects of Epidural Analgesia on Hemodynamic, Oxygenation and Metabolic Variables in the Immediate Postanesthetic Period (II)

Fourteen adult non-diabetic patients undergoing elective major abdominal surgery were divided into 2 groups. One group received epidural and general anesthesia, and a mixture of 0.125% bupivacaine and 2mg of morphine was administered epidurally about 30 minutes before the end of general anesthesia for relief of post surgical pain. The other control group received general anesthesia only with nitrous oxide, oxygen and enflurane. Flow directed pulmonary arterial and radial arterial catheters were inserted preoperatively, and hemodynamic and respiratory variables were measured serially. Blood was drawn serially and catecholamines, cortisol, aldosterone, insulin, blood sugar, free fatty acid and ketone bodies were measured. The data were compared before and after recovery stage of general anesthesia. In control group, epinephrine level at the recovery stage of anesthesia increased about 5 times compared to the anesthetic stage. Oxygen consumption and oxygen extraction ratio were increased and mixed venous oxygen saturation was decreased significantly. There was a close linear correlation between oxygen consumption (Y) and epinephrine (X) level. That is, Y=285.7X+90.5 (p