Thoracic epidural anesthesia decreases stress hyperglycemia in patients undergoing major abdominal sur-gery / 临床麻醉学杂志

ABSTRACT

Objective To investigate the impact of thoracic epidural anesthesia on stress hyper-glycemia in patients undergoing major abdominal operations.Methods Forty patients were divided in-to two groupsgeneral anesthesia (group I)and thoracic epidural and general anesthesia (group E). The venous samples were collected for the measurements of blood glucose (Glu),nitric oxide (NO), malonadialdehyde (MDA),glutathione (GSH)and the activities of aldose reductase (AR),glucose-6-phasphate dehydrogenase (G-6PD), glutathione peroxidase (GSH-Px), superoxide dismutase (SOD),catalase(CAT)in red blood cells at 30 min before induction (T0 ),90 min after incision (T1 ),60 min after surgery (T2 )and on the 1st,2nd postoperative day (T3 and T4 ).Results The lev-el of Glu was increased from T1 to T3 in two groups compared with T0 .The activities of AR,G-6PD and CAT in RBC and plasma MDA were increased markedly at T3 while plasma levels of GSH and NO were decreased significantly in group I (P<0.05).Above parameters,except Glu,changed slightly and did not reach significance in group E.Compared to group I,the level of Glu and the activities of AR,G-6PD,CAT in group E were decreased and NO level was increased significantly at T3 (P <0.05).SOD and GSH-Px activity changed slightly within and between two groups.Conclusion Tho-racic epidural anesthesia can effectively attenuate stress hyperglycemia in patients undergoing major abdominal surgery.