Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 
  • Users Online: 471
  • Home
  • Print this page
  • Email this page
ORIGINAL RESEARCH REPORT
Year : 2018  |  Volume : 15  |  Issue : 4  |  Page : 194-200

Does the anesthetic technique influence the epinephrine and norepinephrine concentration during pelvic surgery?


1 Department of Anaesthesia, College of Medicine, University of Lagos and Lagos University Teaching Hospital, Lagos, Nigeria
2 Department of Anaesthesia, Igbobi Orthopaedic Hospital, Lagos, Nigeria
3 Department of Obstetrics, College of Medicine, University of Lagos and Lagos University Teaching Hospital, Lagos, Nigeria

Correspondence Address:
Dr. Oyebola Olubodun Adekola
Department of Anaesthesia, College of Medicine, University of Lagos and Lagos University Teaching Hospital, P.M.B 12003, Surulere, Lagos
Nigeria
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jcls.jcls_52_18

Rights and Permissions

Background: Epinephrine and norepinephrine concentrations increase by up to ten-fold immediately after surgical injury depending on the severity of the injury. However, the plasma levels of epinephrine and norepinephrine do not necessarily increase concurrently. The plasma epinephrine levels increase for about 48 h, while the norepinephrine levels remain elevated for about 8-10 days after injury. The choice of anesthesia has been shown to influence the secretion of epinephrine and norepinephrine. Materials and Methods: We compared the effects of balanced combined spinal-epidural anesthesia (CSEA, n = 20) and general anesthesia relaxant (GAR, n = 20) on epinephrine and norepinephrine concentrations during major pelvic surgery in patients with uterine mass > 20 weeks gestation. Blood samples for epinephrine and norepinephrine were analyzed at preinduction and 1, 3, and 4 h after surgical incision using enzyme-linked immunosorbent assay technique. Results: The mean norepinephrine concentration differs significantly after incision; at 1 h, CSEA 230.11 ± 42.85 versus GAR 51.25 ± 29.15 pg/ml, P = 0.015; and at 3 h, CSEA 116.22 ± 39.91 versus GAR 27.00 ± 19.89 pg/ml, P = 0.045. The norepinephrine concentrations increased from preinduction values after incision; at 1 h, increased in CSEA by +168% but increased in GAR by +31.7%; at 3 h, increased in CSEA by +35.64% but decreased in GAR by -22.85%; while at 4 h, decreased in CSEA by −3.37% but increased in GAR by +38.94% , P = 0.04 [Figure 2]. The mean epinephrine was comparable during the study, P > 0.05, while the mean heart rate, mean arterial blood pressure, and estimated blood loss were significantly lower with CSEA. Conclusion: We have demonstrated that in patients with uterine mass >20 weeks gestation, CSEA when compared to general anesthesia resulted in an initial increase in mean norepinephrine concentration 1 h after surgical incision followed by gradual decrease toward preinduction values.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed51    
    Printed4    
    Emailed0    
    PDF Downloaded10    
    Comments [Add]    

Recommend this journal