Effects of extradural analgesia and vagal blockade on the metabolic and endocrine response to upper abdominal surgery

Abstract

The effect of thoracic extradural analgesia and vagal blockade on the metabolic t -1 endocrine responses to cholecystectomy was investigated. In comparison with a control grjf patients, extradural analgesia and vagal blockade abolished the glycaemic response to surgr jut had no effect on the increase in plasma cortisol. Circulating insulin values were significantly decreased m the extradural group of patients, confirming the importance of autonomic innervatir in maintaining basal insulin output. There is, at present, no satisfactory local analgesic technique for controlling the endocrine response to upper abdominal surgery. © 1982 Macmillan Publishers Ltd.