[Variations in vasopressin (ADH)-levels during NLA combined with epidural fentanyl-analgesia (author's transl)]. / Plasma-ADH-Spiegel unter kombinierter Neurolept-Analgesie/Peridurale Opiat-Analgesie.

ABSTRACT

10 patients scheduled for thoracic, abdominal or vascular surgery received anaesthesia as a combination of neuroleptanalgesia plus epidural opiate-analgesia. Antidiuretic hormone levels (ADH), serum-electrolytes (Na+, K+) and plasma osmolality have been investigated preoperatively (twice), intraoperatively (six times), during the first postoperative day (three times) and for five days postoperatively (once a day). There was a significant increase in ADH in all patients intra- and postoperatively, whereas serum-electrolytes and plasma-osmolality stayed within normal range. Maximum ADH-values were measured during the intraoperative period, postoperatively ADH-levels reached the normal range after 5 days. This increase in plasma-ADH-levels was not accompanied by typical haemodynamic changes. From the aspect of metabolic endocrine response to surgery, our results indicate no advantage of the combination of neurolept-analgesia plus epidural opiate-analgesia for the intraoperative period.