Radical Cystectomy as a Cause of an Increased Neuroendocrine Response

The present study compared the neuroendocrine response in patients undergoing conventional cystectomy with two postoperative pain management techniques: epidural analgesia (EA) and intermittent opioid (IOA) on adrenocorticotropic hormone (ACTH), cortisol, glucose levels for 48 hours. We hypothesize that appropriate analgesic regime can attenuate stress reaction. Forty-four scheduled radical were assigned to one of groups: group A (n=22) EA, B IOA. surgical factor induced significant hypothalamic-pituitary-adrenal (HPA) axis responses both groups. ACTH cortisol higher than baseline groups, but more significantly B. Blood level was elevated few hours after intervention back by following morning. results suggest EA might have advantages associated reduced attenuated when open access is preferred operative technique. There a need randomized multicentre trials evaluate quality life, survival role at least 12 months cystectomy.