Key result
Combined spinal epidural anaesthesia significantly reduced mean cortisol concentration 4 hours after incision compared to balanced general anaesthesia (19.96 vs 38.94 µg/dl, p=0.018) during major gynaecological operations.
Why the study?
Does combined spinal epidural anaesthesia reduce cortisol and insulin levels compared to balanced general anaesthesia in women undergoing major gynaecological surgeries?
Population
40 ASA I and II status female patients, aged 20-60 years, scheduled for elective myomectomy or total…
Comparison
Combined spinal epidural anaesthesia extending… vs Balanced general anaesthesia (BGA)
Design
RCT, Randomization was performed using the sealed envelope technique
Follow-up
24 hours after incision
Authors
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Supports combined spinal epidural over general anaesthesia to blunt surgical stress in gynaecological procedures; extends RCT evidence on regional techniques' metabolic effects.
RCT (n=40)
Sealed envelope technique
No
Does combined spinal epidural anaesthesia reduce cortisol and insulin levels compared to balanced general anaesthesia in women undergoing major gynaecological surgeries?
Absolute Event Rate: 19.96% vs 38.94%
p-value: p=0.018
Combined spinal epidural anaesthesia extending from T5 to S5 attenuates the stress response, resulting in lower cortisol and glucose concentrations during major gynaecological surgeries compared to balanced general anaesthesia.
Adekola et al. (2014) conducted an RCT in Major gynaecological surgeries (huge fibromyoma) (n=40). Combined spinal epidural anaesthesia vs. Balanced general anaesthesia was evaluated on Mean cortisol concentration 4 hours after incision (µg/dl) (p=0.018). Combined spinal epidural anaesthesia significantly reduced mean cortisol concentration 4 hours after incision compared to balanced general anaesthesia (19.96 vs 38.94 µg/dl, p=0.018) during major gynaecological operations.
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