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Effect of thoracic epidural etidocaine 1.5% on somatosensory evoked potentials, cortisol and glucose during cholecystectomy
Author(s) -
Dahl J. B.,
Rosenberg J.,
Kehlet H.
Publication year - 1992
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.1399-6576.1992.tb03484.x
Subject(s) - medicine , anesthesia , somatosensory evoked potential , stimulation , cholecystectomy , blockade , receptor
The effect of thoracic (T 7–8 ) epidural etidocaine 1.5%, 9 ml, and continuous per‐ and postoperative epidural infusion of etidocaine 1.5%, 4 ml/h, on early (?<500 ms) somatosensory evoked potentials (SEPs), and cortisol and glucose in plasma during cholecystectomy, was examined in ten patients. Spread of analgesia (pin‐prick) was T 3 (T 1 –T 3 ) to L 2 (T 11 –L 3 ) 35 min after injection of etidocaine, and T 3 (T 2 –T 4 ) to T 12 (T 8 –L 4 ) 3 h after surgical incision (median (range)). Before operation, epidural etidocaine had no significant effects on peak‐to‐peak amplitude of SEPs to electrical stimulation at the L 1 T 10 or T 6 dermatomal level ( P >0.09). SEPs were abolished in only two patients at T 6 , and no patient had SEPs abolished at T 10 or L 1 . The plasma concentrations of cortisol and glucose were significantly increased 20 min after surgical incision and remained increased throughout the study. No correlation was found between the block‐induced decrease in the peak‐to‐peak amplitude at T 6 or T 10 and increase in plasma cortisol, except for a negative correlation at T 10 and the initial increase in cortisol (Rs = 0.72, P = 0.03). In conclusion, thoracic epidural administration of 9 ml of etidocaine 1.5% does not provide total afferent somatic blockade assessed by SEP and the stress response to cholecystectomy.