Effects of epidural anaesthesia on intestinal oxygenation in pigs

被引:28
作者
Vagts, DA
Iber, T
Szabo, B
Haberstroh, J
Reising, K
Puccini, M
Geiger, K
Nöldge-Schomburg, GFE
机构
[1] Univ Rostock, Klin & Poliklin Anasthesiol & Intens Therapie, D-18055 Rostock, Germany
[2] Univ Freiburg, Inst Expt & Klin Pharmakol & Toxikol, D-79104 Freiburg, Germany
[3] Univ Freiburg, Chirurg Klin, D-79106 Freiburg, Germany
[4] Univ Freiburg, Anaesthesiol Klin, D-79106 Freiburg, Germany
关键词
anaesthetic techniques; epidural; gastrointestinal tract; mucosal perfusion; partial pressure; carbon dioxide; sympathetic nervous system; pig;
D O I
10.1093/bja/aeg039
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Background. Perioperative intestinal hypoperfusion is a major contributing factor leading to organ dysfunction. It can be caused by stress as a result of surgical manipulation or hypoxia. Additionally, anaesthesia can affect intestinal oxygenation. This animal study was designed to assess the effects of reduced regional sympathetic nervous activity induced by thoracic epidural anaesthesia on intestinal oxygenation. Methods. After ethical approval, 16 anaesthetized and acutely instrumented pigs were randomly assigned to two groups (epidural anaesthesia alone vs epidural anaesthesia plus volume loading). The epidural anaesthesia aimed for a T5-T12 block. Measurements were at baseline and after 1 and 2 h. Results. Epidural anaesthesia was associated with a decrease in mean arterial blood pressure and pronounced mesenteric vasodilatation. Mesenteric blood flow did not change. Intestinal oxygen uptake, mucosal tissue oxygen partial pressure and tissue carbon dioxide partial pressure remained unchanged. Conclusions. Despite marked systemic hypotension, epidural anaesthesia did not affect intestinal oxygenation. There was no benefit obtained from volume loading.
引用
收藏
页码:212 / 220
页数:9
相关论文
共 28 条
[1]   CONFIDENCE-INTERVALS FOR RESEARCH FINDINGS [J].
ALTMAN, DG ;
GARDNER, MJ .
BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 1992, 99 (02) :90-91
[2]   CIRCULATORY EFFECTS OF PERIDURAL BLOCK .1. EFFECTS OF LEVEL OF ANALGESIA AND DOSE OF LIDOCAINE [J].
BONICA, JJ ;
BERGES, PU ;
MORIKAWA, KI .
ANESTHESIOLOGY, 1970, 33 (06) :619-+
[3]  
BRIDENBAUGH PO, 1972, ANESTH ANALG, V2, P280
[4]   DIFFERENTIAL CONTROL OF SYMPATHETIC ACTIVITY TO KIDNEY AND SKELETAL-MUSCLE BY VENTRAL MEDULLARY NEURONS [J].
DEAN, C ;
SEAGARD, JL ;
HOPP, FA ;
KAMPINE, JP .
JOURNAL OF THE AUTONOMIC NERVOUS SYSTEM, 1992, 37 (01) :1-10
[5]   INFLUENCE OF EPIDURAL ANALGESIA ON THE CATECHOLAMINE AND CYCLIC-AMP RESPONSES TO SURGERY [J].
ENGQUIST, A ;
FOGMOLLER, F ;
CHRISTIANSEN, C ;
THODE, J ;
VESTERANDERSEN, T ;
NISTRUPMADSEN, S .
ACTA ANAESTHESIOLOGICA SCANDINAVICA, 1980, 24 (01) :17-21
[6]   CENTRAL HEMODYNAMICS AND REGIONAL BLOOD FLOWS DURING THORACIC EPIDURAL ANALGESIA COMBINED WITH POSITIVE PRESSURE VENTILATION - AN EXPERIMENTAL-STUDY IN THE PIG [J].
FEUK, U ;
JAKOBSON, S ;
NORLEN, K .
ACTA ANAESTHESIOLOGICA SCANDINAVICA, 1987, 31 (06) :479-486
[7]   GASTRIC INTRAMUCOSAL PH, TISSUE OXYGENATION AND ACID-BASE-BALANCE [J].
FIDDIANGREEN, RG .
BRITISH JOURNAL OF ANAESTHESIA, 1995, 74 (05) :591-606
[8]   DENERVATION OF THE SPLANCHNIC VISCERA FOR THE TREATMENT OF SHOCK [J].
FINE, J .
AMERICAN JOURNAL OF SURGERY, 1964, 107 (05) :723-724
[9]  
GELMAN SI, 1976, ARCH SURG-CHICAGO, V111, P881
[10]   How to assess sympathetic activity in humans [J].
Grassi, G ;
Esler, M .
JOURNAL OF HYPERTENSION, 1999, 17 (06) :719-734