Spinal-general anaesthesia decreases neuroendocrine stress response in laparoscopic cholecystectomy.

Objective: A randomized clinical study to compare the stress response to laparoscopic cholecystectomy during spinal-general anaesthesia and epidural- general anaesthesia.

Methods: Women undergoing elective laparoscopic chole cystectomy were assigned to receive either spinal anaesthesia (SA group; n = 12) or epidural anaesthesia (EA group; n = 12), in addition to general anaesthesia. Plasma concentrations of cortisol, adrenocorticotrophic hormone (ACTH), noradrenaline, adrenaline and total catecholamines were measured pre- and intraoperatively.

Results: Intraoperative cortisol, noradrenaline and total catecholamine levels were significantly lower in the SA group compared with the EA group. When pre- and intraoperative values were compared, the SA group showed a decrease in adrenaline, noradrenaline and total catecholamine levels, and the EA group showed an increase in ACTH and noradrenaline levels.

Conclusions: The type of regional anaesthesia significantly affected the stress response: spinal anaesthesia produced a more favourable endocrine response than epidural anaesthesia. Spinal-general anaesthesia may reduce postoperative morbidity in laparoscopic cholecystectomy.