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.
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.
Authors: A L M Tavy; A F J de Bruin; K van der Sloot; E C Boerma; C Ince; P G Noordzij; D Boerma; M van Iterson Journal: World J Surg Date: 2018-12 Impact factor: 3.352
Authors: Jörn Adolphs; Diego K Schmidt; Ines Korsukewitz; Britta Kamin; Helmut Habazettl; Michael Schäfer; Martin Welte Journal: Intensive Care Med Date: 2004-08-26 Impact factor: 17.440
Authors: Rikard Ambrus; Rune B Strandby; Niels H Secher; Kim Rünitz; Morten B S Svendsen; Lonnie G Petersen; Michael P Achiam; Lars B Svendsen Journal: BMC Anesthesiol Date: 2016-10-06 Impact factor: 2.217