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Epidural diamorphine and the metabolic response to upper abdominal surgery
Author(s) -
NORMANDALE J. P.,
SCHMULIAN C.,
PATERSON J. L.,
BURRIN J.,
MORGAN M.,
HALL G. M.
Publication year - 1985
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.1985.tb10998.x
Subject(s) - medicine , anesthesia , abdominal surgery , heroin , cholecystectomy , epidural administration , surgery , morphine , pharmacology , drug
Summary The effect of the administration of diamorphine 10 mg epidurally on the metabolic response to cholecystectomy was investigated and compared with a control group of patients given intravenous papaveretum. There were no significant differences in blood glucose, lactate and pyruvate, and plasma nonesterified fatty acid values between the epidural diamorphine group and the control group. Plasma cortisol concentrations were significantly lower in the epidural diamorphine group postoperatively and this was associated with a marked improvement in pain relief. We conclude that epidural opiates do not directly influence the metabolic response to surgery, but decrease the cortisol response postoperatively secondary to improved analgesia.