Modifying infant stress responses to major surgery: Spinal vs extradural vs opioid analgesia

Andrew R. Wolf, Eddie Doyle, Eric Thomas

Research output: Contribution to journalArticlepeer-review

90 Scopus citations

Abstract

Twenty-six infants due to undergo major abdominal or thoracic surgery under general anaesthesia were randomized to receive additional analgesia with group A) spinal/epidural analgesia; B) epidural analgesia or C) opioid analgesia with fentanyl. We wished to determine if spinal analgesia followed by epidural analgesia might result in more complete control of cardiovascular or stress responses than the other two treatment groups. Heart rate and blood pressure were recorded at five min intervals throughout surgery. Blood samples were taken for measurement of catecholamines and whole blood sugar on induction, 45 min after skin incision and at the end of surgery. Heart rate rose significantly at the start of surgery in groups B and C but not group A. Systolic blood pressures were higher in group C compared to A and B. The rise in plasma glucose concentrations was significantly different between the groups in the order C>B>A (P<0.05). A similar trend was seen in the plasma adrenaline and noradrenaline concentrations but this failed to achieve significance due to the limited sample size.

Original languageEnglish (US)
Pages (from-to)305-311
Number of pages7
JournalPaediatric Anaesthesia
Volume8
Issue number4
DOIs
StatePublished - 1998

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Anesthesiology and Pain Medicine

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