Blood Glucose, Insulin, Antidiuretic Hormone and Renin Activity Response During Caesarean Section Performed Under General Anaesthesia or Epidural Analgesia

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Abstract
Glucose loading caused a significant increase in insulin response (IRI) in patients undergoing cesarean section, both under general anesthesia and under epidural analgesia. After a fast i.v. glucose loading given just before the administration of epidural bupivacaine, similar but more variable serum immunoreactive insulin levels were found as compared with those determined after a slower i.v. glucose infusion in patients under general anesthesia. Plasma renin activity values did not change significantly in either group, but differing from general anesthesia, antidiuretic hormone levels (ADH) increased significantly in patients under epidural analgesia. The changes in IRI and ADH response may be caused by a higher psychic stress reaction of the conscious patients during cesarean section under epidural analgesia.