| Sympatho-adrenal and pituitary hormone responses during and immediately after thoracic surgery--modulation by four different pain treatments. | |
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MedLine Citation:
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PMID: 3434168 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Four different pain treatments (single intercostal block with bupivacaine, repeated intercostal block, epidural morphine and epidural bupivacaine infusions) were compared in 39 patients subjected to lung surgery under general anaesthesia. The patients' own estimate of the postoperative pain was not significantly different between the groups, but the epidurally treated patients required fewer doses of supplementary analgesic than those given just a single dose of intercostal bupivacaine. Bupivacaine levels in blood were below the toxic range in all groups. The concentration of antidiuretic hormone in blood was increased early during the operation, and had only partly returned to normal on the first postoperative morning. Growth hormone in plasma was increased only at the end of the operation. Catecholamine levels in blood increased gradually, reaching their peak postoperatively. There were only slight differences between the groups in these posterior and anterior pituitary and sympatho-adrenal responses to surgical stress. Thus, neither repeated intercostal blockade nor epidural administration of morphine or bupivacaine could prevent the endocrine responses to thoracic surgery, in spite of significant, albeit incomplete, pain relief. This was probably caused in part by residual pain, and also by poor access of the extradural medications to the autonomic afferent pathways mediating nociceptive signals from thoracic organs and tissues. |
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Authors:
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B Scheinin; M Scheinin; R Asantila; R Lindberg; O Viinamäki |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Acta anaesthesiologica Scandinavica Volume: 31 ISSN: 0001-5172 ISO Abbreviation: Acta Anaesthesiol Scand Publication Date: 1987 Nov |
Date Detail:
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Created Date: 1988-03-10 Completed Date: 1988-03-10 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0370270 Medline TA: Acta Anaesthesiol Scand Country: DENMARK |
Other Details:
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Languages: eng Pagination: 762-7 Citation Subset: IM |
Affiliation:
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Department of Anaesthesiology, Surgical Hospital, Helsinki University Central Hospital, Finland. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Anesthesia, Conduction Anesthesia, Epidural Bupivacaine / therapeutic use Catecholamines / blood* Female Growth Hormone / blood* Humans Lung Neoplasms / surgery* Male Middle Aged Morphine / therapeutic use Pain Measurement Pain, Postoperative / blood, drug therapy* Time Factors Vasopressins / blood* |
| Chemical | |
Reg. No./Substance:
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0/Catecholamines; 11000-17-2/Vasopressins; 2180-92-9/Bupivacaine; 57-27-2/Morphine; 9002-72-6/Growth Hormone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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