Abstract

The authors focus on the influence of spinal anaesthesia and the epidural one on the quality of the blackade and on the matabolic-hormonal response evoked by the total hip replacement. Among 120 patients who have been investigated, 80 were anaesthetized by the spinal anaesthesia and 40 by the epidural one, in both cases 0.5% bupivacaine (Marcaine, Astra) was used. The authors investigated the onset-time and the range of the blockade, the level of motor blockade and the duration of sensory blockade. They also measured heart rate, systolic and diastolic blood pressure, the concentration of glucose, cortisol, TT3, TT4 and beta-endorphine in blood serum. On the basis of the above examinations the authors found out that the spinal anaesthesia affected the necessary range of blockade sooner than epidural anaesthesia. The depression of circulation was comparative in both kinds of anaesthesia. The spinal anaesthesia in comparison with the epidural one caused lesser growth of glucose, cortisol and beta-endorphine concentration in blood serum, while the growth of TT3 and TT4 was similar in both cases. It seems that the spinal anaesthesia is a better solution in total hip replacement.

Keywords: total hip replacement, spinal anaesthesia, epidural anaesthesia, beta-endorphine, Cortisol, Thyroid Hormones, Glucose