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September 1, 1989Anesthesia & Analgesia

Nitrogen-Sparing Effect of Epidural Administration of Local Anesthetics in Colon Surgery

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Why the study?

Does epidural administration of local anesthetics improve nitrogen balance and reduce skeletal muscle protein catabolism in patients undergoing colon resection for cancer?

Population

28 patients who had undergone colon resection for cancer

Comparison

General anesthesia plus epidural injection of… vs General anesthesia supplemented with low dose…

Design

Cohort

Follow-up

6 days

Authors

CVC. VédrinneHôpital Louis PradelJVJ VédrinneClinique du Grand LargeMGM. GuiraudHôtel-Dieu de Lyon

Discussion

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Implication

May reduce postoperative catabolism after colon resection; hypothesis-generating for epidural effects on muscle protein metabolism.

Structured PICO

Does epidural administration of local anesthetics improve nitrogen balance and reduce skeletal muscle protein catabolism in patients undergoing colon resection for cancer?

P
Population
28 patients who had undergone colon resection for cancer
I
Intervention
General anesthesia (N2O-O2-1% enflurane) plus epidural injection of either etidocaine 1% intraoperatively and bupivacaine 0.25% postoperatively (n=8) or meperidine (n=7) for 48 hr after skin incision
C
Comparator
General anesthesia (N2O-O2-1% enflurane) supplemented with low dose fentanyl plus intermittent systemic pentazocine for postoperative pain (n=13)
O
Outcome
Postoperative nitrogen balance and 3-methylhistidine urinary excretion for 6 dayssurrogate

Epidural analgesia with local anesthetics in the postoperative period improves nitrogen balance and reduces muscle protein catabolism in patients undergoing colon surgery.

Cite This Study

Védrinne et al. (1989) studied this question.

synapsesocial.com/papers/6a7faa61138fa0ec199fea65https://doi.org/10.1213/00000539-198909000-00014
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Effects of epidural administration of local anaesthetics or morphine on postoperative nitrogen loss and catabolic hormones1987 · 46 citations
  2. 2Epidural analgesia improves postoperative nitrogen balance.1978 · 167 citations
  3. 3Intraoperative epidural blockade prevents the increase in protein breakdown after abdominal surgery2001 · 19 citations
  4. 4A Controlled Study on the Effect of Epidural Analgesia with Local Anaesthetics and Morphine on Morbidity after Abdominal Surgery1985 · 139 citations
  5. 5The Effect of General Anesthesia and Thoracic Epidural Analgesia on Stress Response and Homocysteine Levels in Major Upper Abdominal Surgery: A Prospective Randomised Study2017