Epidural anesthesia alters stress response to surgery in children

ABSTRACT

The endocrinal response to surgical stress in lower abdomen and lower limb operations in 30 children, has been studied. Children were randomly allocated in one of two groups, each contained 15 children [N = 15]. Group 1 "control" received general anesthesia, while group 2 "epidural" received lumbar epidural blockade, in addition to light general anesthesia. Plasma cortisol and blood glucose levels have been estimated after induction of general anesthesia [control sample C], one, two and three hours later [1Hr, Hrs. and 3Hrs.]. It was found that plasma cortisol and blood glucose levels have significantly increased in group 1 "control" after one, two and three hours from start of surgery. On the other hand, in group 2 "epidural", the blockade of neurogenic impulses from site of surgery succeeded in attenuating these responses as evidenced by significantly lower plasma cortisol levels after two and three hours from the start of surgery compared to control value. Epidural anesthesia also succeeded in attenuating the hyperglycemic response to surgical stress as evidenced by a blood glucose level significantly lower in epidural group than control group at all intervals except for control sample. Therefore, epidural anesthesia can be considered a valuable technique to minimize the catabolic consequences of surgical stress in children. This can be of special value in high-risk children with poor nutritional status