Epidural anesthesia during hysterectomy diminishes postoperative pain and urinary cortisol release

Tomoko Yorozu, Hiroshi Morisaki, Masahiro Kondoh, Kazuo Tomizawa, Masato Satoh, Toshiyuki Shigematsu

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


Purpose: To examine the hypothesis that epidural anesthesia throughout lower abdominal surgery would depress both postoperative pain and cortisol release. Methods: Forty adult patients undergoing abdominal total hysterectomy were studied. The patients were randomly assigned to two groups. Group G received general anesthesia alone (sevoflurane 1.5%-2.5%); group E received a combination of epidural anesthesia (1.5% mepivacaine) with a light plane of general anesthesia (sevoflurane<0.5%). Postoperative analgesia was obtained epidurally by patient-controlled analgesia. Postoperative pain at rest and during movement was assessed by a visual analogue scale (VAS) at 2, 24, and 48 h following surgery. The plasma concentration and urinary excretion of cortisol were measured during the perioperative period. Results: VAS values were lower in group E than in group G during movement at 24h (4.6±0.5 vs 6.1±0.4 cm). Urinary cortisol excretion on the first postoperative day was less in group E than in group G (192±34 vs 480±120μg). Conclusions: Epidural blockade prior to surgical stimuli and throughout lower abdominal surgery reduces the postoperative dynamic pain and stress response.

Original languageEnglish
Pages (from-to)260-264
Number of pages5
JournalJournal of Anesthesia
Issue number4
Publication statusPublished - 1997 Dec


  • Cortisol
  • Epidural anesthesia
  • Hysterectomy
  • Preemptive analgesia
  • Visual analogue scale

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine


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