Effect of continuous epidural blockade and PCEA on the stress change response to upper abdomen surgery

Abstract

Objective To observe and compare the effect of continuous epidural blockade and PCEA on the stress charge response to upper abdomen surgery. Methods Thirty patients undergoing upper abdomen surgery were randomized to receive either combined general anesthesia with postoperative patient-controlled epidural analgesia (PCEA) (EA group,n=15) or general anesthesia with postoperative patient-controlled intravenous analgesia (PCIA) (GA group,n=15). The stress response was quantitated by measuring of plasma norepinephrine, epinephrine, serum cortisol, adrenocorticotropin (ACTH),at pre-induction,2 hours after incision, at the end of operation,and on the morning of postoperative in the 1(POD1) and 3 (POD3) day. Results There were no changes in plasma norepinephrine and cortisol concentrations in GA group, but there were significant increases at the end of surgery and on POD1 in GA group (P 0.05). Conclusions Continuous epidural blockade and PCEA could reduce the stress response toupper abdomen surgery. Key words: Continuous epidural block ; Patient controlled epidural analgesia ; Upper abdomen surgery ; Stress ; Effect ;