METABOLIC RESPONSE TO COLONIC SURGERY - EXTRADURAL VS CONTINUOUS SPINAL

We have examined the effect of intraoperative and postoperative (4 h) continuous spinal anaesthesia for colonic surgery on the postoperative glucose, lactate and cortisol responses. Twenty-one patients were studied; the first group (control) received general anaesthesia, the second group (extradural) an extradural block (T4-S5) and the third group (spinal) a continuous spinal block (T4-S5). Plasma concentration of glucose increased significantly in the control and extradural groups (P < 0.05) after surgery, with a small change in the spinal group. Plasma concentration of lactate increased significantly (P < 0.05) in the control group only. The postoperative increase in plasma concentration of cortisol was similar in both control and extradural groups, and significantly greater than that of the spinal group (P < 0.05). Thus continuous spinal analgesia attenuated, but did not abolish, the increase in plasma concentration of cortisol associated with colonic surgery.