Influence of Epidural Analgesia on Postoperative Changes in Various Serum Enzyme Patterns and Serum Bilirubin

Abstract

Postoperative changes in serum bilirubin, various serum enzymes (alanine-amino transferase (ALAT), alkaline phosphatase (AP), lactate dehydrogenase (LDH) and creatine phosphokinase (CPK)), plasma glucose and cortisol were studied in 20 healthy, premenopausal women undergoing elective abdominal hysterectomy under either general anesthesia with halothane or epidural analgesia (T[thoracic]4-S[sacral]5). Surgery under general anesthesia was followed by increased levels of bilirubin, LDH, CPK, glucose and cortisol AP and ALAT were unaffected by surgery. Epidural analgesia inhibited increases in LDH, CPK, glucose and cortisol (P < 0.05), but not the increase in bilirubin. Afferent neurogenic stimuli from the surgical area appear to be important in mediating the postoperative changes in LDH and CPK; factors other than neurogenic stimuli or adrenal hormones apparently are responsible for the postoperative changes in bilirubin.