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Per‐ and postoperative changes in the concentration of serum thyreotropin under general anaesthesia, compared to general anaesthesia with epidural analgesia
Author(s) -
Noreng M. F.,
Jensen P.,
Tjelldén N. U.
Publication year - 1987
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1987.tb02569.x
Subject(s) - medicine , anesthesia , bupivacaine , pethidine , epidural space , triiodothyronine , hormone , general anaesthesia , plasma concentration , analgesic , nitrous oxide
In 18 patients scheduled for lower intraabdominal surgery (hysterectomy), changes in thyreotropin (TSH) thyroxine (T 4 ), triiodothyronine (T 3 ) binding of thyroid hormones to plasma proteins (T 3 ‐uptake) and glucose in serum were evaluated. In eight patients afferent neurogenic impulses from the surgical area were blocked (Th 4 ‐S 5 ) with bupivacaine 0.5% infused continuously into the epidural space from the start of the operation until 6 h postoperatively. All patients received general anaesthesia with thiopentone, pethidine, pancuronium and nitrous‐oxide plus oxygen. The patients receiving epidural analgesia had no increase in plasma‐TSH, compared to the other group, which had a significant ( P < 0.05) increase peroperatively. The patients receiving epidural analgesia were pain‐free and the normal stress‐induced increase in plasma‐glucose was abolished. Concerning T 3 we found a significant decrease in both groups and a steady level of T 4 ‐ and T 3 ‐uptake without significant fluctuations. Thus it can be concluded that the effects of surgical trauma on plasma‐TSH concentration are markedly similiar to the effects of other anterior pituritary hormones, i.e. HGH, prolactin and ACTH.