Skip to main content
SpringerLink
Log in

Der Einfluß einer kontinuierlichen Periduralanästhesie auf den perioperativen Stoffwechsel und eine postoperative Ernährungstherapie

  • Conference paper
ZAK Zürich

  • 25 Accesses

Zusammenfassung

Bei jeder Art von Streß und Aggression — eine Operation ist nur eine von vielen Möglichkeiten — kommt es zum Zusammenfließen vieler Informationen im Hypothalamus, wo den zentralen Schaltstellen signalisiert wird, daß dem Organismus Gefahr droht. Die Reaktion darauf ist eine Mobilisierung aller Abwehrmechanismen (Fight and flight reaction), die Umschaltung auf körpereigene Energiesubstratbereitstellung, das Einsparen von Natrium und Wasser durch verstärkte Retention sowie eine Drosselung des Energieumsatzes, wenn die Situation dies zuläßt.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 54.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 69.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. Altemeyer K-H, Breucking E, Fösel T, Dick W (1983) Veränderungen der Stoffwechselregulation unter dem Einfluß von Narkose und Operation im Kindesalter. In: Pohland F (Hrsg) Pädiatrische Intensivmedizin, V. Thieme, Stuttgart New York, S 21

    Google Scholar 

  2. Altemeyer K-H, Seeling W, Breucking E, Feist H, Schmitz JE, Beischer W, Ahnefeld FW (1983) Untersuchungen zur Streßreaktion bei Knieoperationen unter kontinuierlicher Periduralanästhesie im Vergleich zur Neuroleptanalgesie. Anaesthesist 32:219–225

    PubMed  CAS  Google Scholar 

  3. Bevan DR (1971) Modification of the metabolic response to trauma under extradural analgesia. Anaesthesia 26:188–191

    Article  PubMed  CAS  Google Scholar 

  4. Bloom SR (1973) Glucagon a stress hormone. Postgrad Med J 49:607–611

    CAS  Google Scholar 

  5. Bonica JJ, Kennedy WF, Akamatsu TJ, Gerbershagen HU (1972) Circulatory effects of peridural block: III. Effects of acute blood loss. Anesthesiology 36:219–227

    Article  PubMed  CAS  Google Scholar 

  6. Bonnet F, Harari A, Thibonnier M, Viars P (1982) Suppression on antidiuretic hormone hypersecretion during surgery by extradural anaesthesia. Br J Anaesth 54:29–36

    Article  PubMed  CAS  Google Scholar 

  7. Bormann B von, Weidler B, Dennhardt R, Frings N, Lennartz H, Hempelmann G (1981) Plasma-ADH-Spiegel als perioperativer Streßparameter. 2. Mitteilung. Anasth Intensivther Notfallmed 16: 319–322

    Article  CAS  Google Scholar 

  8. Brandt M, Kehlet H, Binder C, Hagen C, McNeilly AS (1976) Effect of epidural analgesia on the glycoregulatory response to surgery. Clin Endocrinol 5:107–114

    Article  CAS  Google Scholar 

  9. Brandt MR, Kehlet H, Skovsted L, Hansen JM (1976) Rapid decrease in plasma-triiodothyronine during surgery and epidural anaesthesia independent of afferent neurogenic stimuli and Cortisol. Lancet 11:1333–1336

    Article  Google Scholar 

  10. Brandt MR, Fernandes A, Mordhorst R, Kehlet H (1978) Epidural analgesia improves postoperative nitrogen balance. Br Med J I:1106–1108

    Google Scholar 

  11. Bromage PR, Shibata HR, Willoughby HW (1971) Influence of prolonged epidural blockade on blood shugar and Cortisol responses to operations upon the upper part of the abdomen and the thorax. Surg Gynecol Obstet 132:1051–1056

    PubMed  CAS  Google Scholar 

  12. Buckley FP, Kehlet H, Brown NS, Scott DB (1982) Postoperative glucose tolerance during extradural analgesia. Br J Anaesth 54:325–330

    Article  PubMed  CAS  Google Scholar 

  13. Burr WA, Griffiths RS, Black EG, Hoffenberg RH, Meinhold H, Wenzel KW (1975) Serum triiodothyronine and reverse triiodothyronine concentrations after surgical operations Lancet II: 1277–1279

    Google Scholar 

  14. Cavalieri RR, Rapoport B (1977) Impaired peripheral conversion of thyroxine to triiodothyronine. Ann Rev Med 28:57–65

    Article  PubMed  CAS  Google Scholar 

  15. Cryer PE (1980) Physiology and pathophysiology of the human sympathoadrenal neuroendocrine system. N Engl J Med 303:436–444

    Article  PubMed  CAS  Google Scholar 

  16. Engquist A, Brandt MR, Fernandes A, Kehlet H (1977) The blocking effect of epidural analgesia on the adrenocortical and hyperglycaemic responses to surgery. Acta Anaesth Scand 21:330–335

    Article  PubMed  CAS  Google Scholar 

  17. Engquist A, Fog-Miller F, Christiansen C, Thode J, Vester-Andersen T, Madsen N (1980) Influence of epidural analgesia on the catecholamine and cyclic AMP responses to surgery. Acta Anaesth Scand 24:17–21

    Article  PubMed  CAS  Google Scholar 

  18. Gelman S, Feigenberg Z, Dintzman M, Levy E (1977) Electroenterography after cholecystectomy. The role of high epidural analgesia. Arch Surg 112:580–584

    PubMed  CAS  Google Scholar 

  19. Gordon NH, Scott DB, Percy Robb IW (1973) Modification of plasma corticosteroid concentrations during and after surgery by epidural blockade. Br Med J I:581–583

    Article  Google Scholar 

  20. Greene NM (1974) Insulin and anaesthesia. Anesthesiology 41:75–79

    Article  PubMed  CAS  Google Scholar 

  21. Hack G, Marx F, Witassek F, Vetter H (1980) Zum Einfluß von Periduralanästhesie und Operation auf das Renin-Angiotensin-AldosteronnSystem. In: Wüst HJ, Zindler M (Hrsg) Neue Aspekte in der Regionalanästhesie. Springer, Berlin Heidelberg New York, S 119

    Google Scholar 

  22. Hagen C, Brandt MR, Kehlet H (1980) Prolactin, LH, FSH, GH and Cortisol response to surgery and the effect of epidural analgesia. Acta Endocrinol (Copenh) 94:151–154

    CAS  Google Scholar 

  23. Halter JB, Pflug AE (1980) Effect of sympathetic blockade by spinal anesthesia on pancreatic islet function in man. Am J Physiol 239:E150-E155

    PubMed  CAS  Google Scholar 

  24. Halter JB, Pflug AE (1980) Relationship of impaired insulin secretion during surgical stress to anesthesia and catecholamine release. J Clin Endocrinol Metab 51.1093–1098

    Article  PubMed  CAS  Google Scholar 

  25. Halter J, Pflug A, Tolas A, Raskind M, Weitzman R (1980) Differential neuroendocrine responses to pain and psychic stress during dental surgery in man. Endocrinology [Suppl] 106:191

    Google Scholar 

  26. Houghton A, Hickey JB, Ross SA, Dupre J (1978) Glucose tolerance during anaesthesia and surgery. Comparison of general and extradural anaesthesia. Br J Anaesth 50:495–499

    Article  PubMed  CAS  Google Scholar 

  27. Ingbar SH, Woeber KA (1981) The thyroid gland. In: Williams RH (ed) Textbook of endocrinology. Saunders, Philadelphia London Toronto, p 117

    Google Scholar 

  28. Jensen CH, Berthelsen P, Kühl C, Kehlet H (1980) Effect of epidural analgesia on glucose tolerance during surgery. Acta Anaesth Scand 24:472–474

    Article  PubMed  CAS  Google Scholar 

  29. Jorrot JC, Clément P, Jeanne L, Laudat MH, Morville R, Poizat R, Lassner J (1983) Asthénie postopératoire et variations de la testostéronémie chez l’homme. Cah Anesthesiol 31:251–256

    Google Scholar 

  30. Kehlet H (1982) The modifying effect of general and regional anaesthesia on the endocrine-metabolic response to surgery. Reg Anesth [Suppl] 7:38–48

    CAS  Google Scholar 

  31. Kehlet H, Brandt MR, Prange Hansen A, Alberti KGMM (1979) Effect of epidural analgesia on metabolic profiles during and after surgery. Br J Surg 66:543–546

    Article  PubMed  CAS  Google Scholar 

  32. Knitza R, Ciasen D, Theiß D, Cordes U (1980) Einfluß der Anästhesiemethode auf das Verhalten von Adrenalin und Noradrenalin während Anästhesie und Operation. In: Wüst HJ, Zindler M (Hrsg) Neue Aspekte in der Regionalanästhesie 1. Springer, Berlin Heidelberg New York (Anaesthesiologie und Intensivmedizin, Bd 124, S 103)

    Google Scholar 

  33. Knoche E, Traub E, Strecker J, Fehm H, Dick W (1981) Untersuchungen zum Verhalten wichtiger metabolischer Parameter in der Peripartialperiode unter dem Einfluß der Periduralanästhesie. Infusionstherapie 8:190–199

    CAS  Google Scholar 

  34. Koßmann B, Spilker D, Fehm HL, Rosenthal I (1982) Einfluß der thorakalen Periduralanästhesie auf die hormonelle Regulation des Wasser-Elektrolyt-Haushaltes. Anaesthesist 31:519–520

    Google Scholar 

  35. Koßmann B, Volk E, Spilker ED, Maier V, Fehm HL (1982) Influence of thoracic epidural analgesia on glucose, Cortisol, insulin, and glucagon response to surgery. Reg Anesth 7:107–109

    Google Scholar 

  36. Meguid MM, Brennan MF, Aoki TT, Muller WA, Ball MR, Moore FD (1973) The role of insulin and glucagon in acute trauma. Surg Forum 24:97–98

    PubMed  CAS  Google Scholar 

  37. Menzies N, Cochrane JPS (1979) The effect of epidural analgesia on postoperative sodium balance. Br J Surg 66:864–867

    Article  Google Scholar 

  38. Newsome HH, Rose JC (1971) The response of human adrenocorticotrophic hormone and growth hormone to surgical stress. J Clin Endocrinol Metab 33:481–487

    Article  PubMed  CAS  Google Scholar 

  39. Nimmo WS (1982) Gastrointestinal function following surgery. Reg Anesth [Suppl] 7:105–109

    Google Scholar 

  40. Nimmo WS, Littlewood DG, Scott DB, Prescott LF (1978) Gastric emptying following hysterectomy with extradural analgesia. Br J Anaesth 50:559–561

    Article  PubMed  CAS  Google Scholar 

  41. Nistrup Madsen S, Fog Miller F, Christiansen C, Vester-Andersen T, Engquist A (1978) Cyclic AMP, adrenaline and noradrenaline in plasma during surgery. Br J Surg 65:191

    Article  Google Scholar 

  42. Pflug AE, Halter JB, Tolas AG (1982) Plasma catecholamine levels during anesthesia and surgical stress. Reg Anesth [Suppl] 7:49–56

    Google Scholar 

  43. Porte D, Robertson RP (1973) Control of insulin secretion by catecholamines, stress and the sympathetic nervous system. Fed Proc 32:1792–1796

    PubMed  CAS  Google Scholar 

  44. Samols E, Weir GC (1979) Adrenergic modulation of pancreatic A, B, and D cells. J Clin Invest 63: 230–238

    Article  PubMed  CAS  Google Scholar 

  45. Scott DB (1982) Cardiovascular effects of lumbar epidural and spinal anesthesia. Reg Anesth [Suppl] 7:21–23

    Google Scholar 

  46. Seeling W, Altemeyer KH, Berg S, Feist H, Schmitz E, Schröder M, Ahnefeld FW (1982) Die kontinuierliche thorakale Periduralanästhesie zur intra- und postoperativen Analgesie. Anaesthesist 31: 439–448

    PubMed  CAS  Google Scholar 

  47. Sefrin P (1981) Polytrauma und Stoffwechsel. Springer, Berlin Heidelberg New York

    Google Scholar 

  48. Shervin RS (1983) Effect of epinephrine on fuel metabolism in man. In: Kleinberger G, Deutsch E (eds) New aspects in clinical nutrition. Karger, Basel München Paris London New York Tokyo Sydney, p 283

    Google Scholar 

  49. Skillman JJ (1983) Should intravenous protein and fat be administered? Surgery 93:469–470

    PubMed  CAS  Google Scholar 

  50. Swanson LW, Sawchenko PE (1980) Nucleus paraventricularis a site for integration of neuroendocrine and autonome mechanisms. Neuroendocrinology 31:410–417

    Article  PubMed  CAS  Google Scholar 

  51. Traynor C, Paterson JL, Ward ID, Morgan M, Hall GM (1982) Effects of extradural analgesia and vagal blockade on the metabolic and endocrine response to upper abdominal surgery. Br J Anaesth 54:319–323

    Article  PubMed  CAS  Google Scholar 

  52. Unger RH (1971) Glucagon physiology and pathophysiology. N Engl J Med 285:443–449

    Article  PubMed  CAS  Google Scholar 

  53. Vinnars E, Vesterberg K (1982) Postoperative nutritional status. Reg Anesth [Suppl] 7:138–140

    Google Scholar 

  54. Weidler B, Bormann B von, Lennartz H, Dennhardt R, Hempelmann G (1981) Plasma-ADH-Spiegel als perioperativer Streßparameter. I. Mitteilung. Anasth Intensivther Notfallmed 16:315–318

    Article  PubMed  CAS  Google Scholar 

  55. Woods SC, Porte D (1974) Neural control of the endocrine pancreas. Physiol Rev 54:596–619

    PubMed  CAS  Google Scholar 

Download references

Authors
  1. W. Seeling
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. K.-H. Altemeyer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. B. Koßmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. E. Schmitz
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Institut für Anästhesiologie, Universitätsspital, Rämistraße 100, CH-8091, Zürich, Switzerland

    Georg Hossli

  2. Institut für Anästhesie und Reanimation, Stadtspital Triemli, Birmensdorferstraße 497, CH-8063, Zürich, Switzerland

    Pius Frey

  3. Abteilung für Anästhesie und Reanimation, Kantonsspital Frauenfeld, CH-8500, Frauenfeld, Switzerland

    Georg Kreienbühl

Rights and permissions

Reprints and permissions

Copyright information

© 1986 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Seeling, W., Altemeyer, KH., Koßmann, B., Schmitz, J.E. (1986). Der Einfluß einer kontinuierlichen Periduralanästhesie auf den perioperativen Stoffwechsel und eine postoperative Ernährungstherapie. In: Hossli, G., Frey, P., Kreienbühl, G. (eds) ZAK Zürich. Anaesthesiologie und Intensivmedizin Anaesthesiology and Intensive Care Medicine, vol 189. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-71270-8_36

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-71270-8_36

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-16619-1

  • Online ISBN: 978-3-642-71270-8

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation