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Influence of Thoracic Epidural Analgesia on Glucose, Cortisol, Insulin, and Glucagon Responses to Surgery
  1. B. Kossman,
  2. E. Völk,
  3. E. D. Spilker,
  4. V. Maier and
  5. H. L. Fehm
  1. From the Centers of Anesthesiology and Internal Medicine, University of Ulm, Ulm, West Germany


The suppression of the glucose response under thoracic epidural anesthesia cannot be explained by the influence of glucagon, insulin, or cortisol. In contrast to the results of Kehlet indicating a suppression of the endocrine response to surgery in gynecologic patients, we could not show a difference in this response during major intraabdominal vascular surgery. The differences in hormonal response found in upper and lower abdominal surgery indicate different nervous pathways as suggested by Bromage or an action of local tissues hormones, both not being able to be suppressed by neural blockade.

  • Epidural analgesia
  • Plasma glucose
  • cortisol
  • insulin
  • Glucagon

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  • Address reprint requests to Dr. med. Kossman: Zentrum für Anästhesiologie de Universität Ulm, Prittwitzstr. 43, D‐7900 Ulm/Donau, Germany.