ArticleTurkish journal of anaesthesiology and reanimation2015
Investigation of Effects of Epidural Anaesthesia Combined with General Anaesthesia on the Stress Response in Patients Undergoing Hip and Knee Arthroplasty.
Article in Turkish journal of anaesthesiology and reanimation, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed, 12 citations in OpenAlex.
- Intrathecal morphine administration reduces postoperative pain and peripheral endocannabinoid levels in total knee arthroplasty patients: a randomized clinical trial.BMC anesthesiology · 2018Trial
- Suppression of perioperative stress response in elective abdominal surgery: A randomized comparison between dexmedetomidine and epidural block.Journal of anaesthesiology, clinical pharmacologyArticle
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4 authors at 1 institution in 1 country.
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Abstract
objectiveTo investigate the effects of general anaesthesia and general+epidural anaesthesia on the stress response which was evaluated with the adrenocorticotrophic hormone (ACTH), cortisol, insulin, and glucose levels and the haemodynamic parameters.
methodsForty two, American Society of Anesthesiologists physiologic status I-II, patients undergoing hip and knee arthroplasty were randomized into two groups; general anaesthesia (Group G) and general anaesthesia+epidural anaesthesia (Group E). Epidural anaesthesia: patients in Group E received epidural anaesthesia with 0.5% bupivacaine, a lumbar epidural catheter was placed and after achieving sensorial block at T10 dermatome, general anaesthesia was commenced. General anaesthesia was standardized in both groups. Further, plasma ACTH, cortisol, insulin and glucose levels were determined at preoperative=t1, after the surgical incision=t2, postoperative 2(nd) hour=t3 and postoperative 24(th) hour=t4. Perioperative heart rate, blood pressures, pain scores and morphine consumption were also determined.
resultsACTH levels were higher in Group G than Group E [Group G, t2: 71.4±39.9 pg mL(-1), t3: 578.6±566.1 pg mL(-1), Group E, t2: 20.2±16.2 pg mL(-1), t3: 56.3±73.6 pg mL(-1) (p<0.001)]. Cortisol, was higher in Group G compared with Group E [Group G, t3: 33.4±13.1 μg dL(-1), t4: 34.1±22.5 μg dL(-1), Group E, t3: 19.1±10.3 μg dL(-1), t4: 21.3±8.1 μg dL(-1) (p=0.001 and p=0.002)]. The insulin levels were higher compared with the baseline values at t3, and glucose was higher at t3 and t4 in both groups. Haemodynamic parameters were stable in Group E, and pain scores and morphine consumption were higher in Group G than in Group E.
conclusionOur results suggest that epidural anaesthesia combined with general anaesthesia suppressed the stress response, which was evaluated with ACTH, cortisol levels and haemodynamic parameters; however, this method was ineffective to attenuate the increase in glucose and insulin levels.
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