Das Verhalten der Plasmakatecholamine nach Bauchoperationen beim Menschen

Abstract

Plasma Catecholamine Levels after A b d o m i n a l Operations in ManSummary. In 13 patients (7 women, 6 men, average age 61 year), who underwent a major abdominal operation and whose postoperative course was uncomplicated, the plasma eatecholamines (noradrenaline and adrenaline) were measured one day before operation, 3 to 5 hours after operation as well as on the first and third postoperative day. The heart rate, central venous and arterial pressure, hemoglobin and body temperature were determined simultaneously.I. In the first postoperative phase total catecholamine mounts to nearly twice the initial value. However, it rises only slightly towards the first postoperative day. On the third postoperative day there is a decreasing tendency.2. Noradrenaline rises already three to five hours postoperatively to its highest mean level, while adrenaline reaches its highest mean level on the first postoperative day.3. Heart rate rises from an average 77/min to 94/rain at the first postoperative day. Central venous pressure decreases toward the first postoperative day by an average of I mmttg, in order to reach its initial value on the third day. Arterial pressure, hemoglobin and body temperature stay unchanged during the period of examination.4. There is a certain quantitative relation between the augmentation of total catecholamine and heart rate.These findings together with relevant literature are discussed and probable causes for raised sympathico-adrenergic activities in the early postoperative phase are demonstrated.

Effect of Epidural Analgesia on the Glycoregulatory Endocrine Response to Surgery

“…The mechanism of the inhibitory effect of pre and postoperative epidural analgesia on the hyperglycaemia response to surgery have not been completely outlined in this study. Possibly it is mediated by an inhibition of another glycoregulatory hormonal system, the catecholamines, known to be secreted in increased amounts during sugery (Eisele et al, 1974).…”

Das Verhalten der hGH-Sekretion bei Schwerverletzten

“…Schwere Traumen führen ebenso wie große chirurgische Eingriffe zu einer Störung des Stoffwechselgleichgewichtes in Richtung Katabolismus (18,27,70,71,72). Er ist primär Folge einer Steigerung des Sympathikotonus (1, 7,12,22,23,30,49,56,68). Von den sich anschließenden komplexen Änderungen im Endoknnium ist auch das Wachstumshormon (hGH) betroffen, wie Untersuchungen bei Operationen und nach Unfällen ergaben (10,19,26,30,45,47,52,56,70,71).…”