Blood Glucose, Insulin, Antidiuretic Hormone and Renin Activity Response During Caesarean Section Performed Under General Anaesthesia or Epidural Analgesia

Glucose loacling caused a significant increase in insulin response (IRI) in patients undergoing caesarean section, both under general Anaesthesia and under epidural analgesia. After a fast intravenous glucose loacling given j ust before the administration of epidural bupivacaine, similar but more variable serum immunoreactive insulin levels were found as compared with those determined after a slower intravenous glucose infusion in patients under general anaesthesia. Plasma renin activity values did not change significantly in either group, but, differing from general anaesthesia, antidiuretic hormone levels (ADH) increased significantly in patients under epidural analgesia. The changes in IRI and ADH response may be caused by a higher psychic stress reaction of the conscious patients during caesarean section under epidural analgesia.