Epidural Anesthesia Retards Intestinal Acidosis and Reduces Portal Vein Endotoxin Concentrations during Progressive Hypoxia in Rabbits

Abstract

The current study showed that epidural anesthesia slowed the progression of intestinal ischemia during acute hypoxia, subsequently preventing translocation of endotoxin through the gut mucosa.

Epidural anaesthesia restores pancreatic microcirculation and decreases the severity of acute pancreatitis

“…Previous reports already showed that EA increased splanchnic venous capacitance and decreased arterial tone by blocking sympathetic nerve activity [21,22,[28][29][30] . It was also reported that EA might increase sympathetic activity and vasoconstriction in organs distant from the anesthetized area and redistributes blood flow towards splanchnic organs [21] .…”

“…Thus, EA can reduce the incidence of post-operative pulmonary complications, and shorten the duration of the post-operative intestinal paralysis [19,20] . In addition, experimental studies have shown that EA increases gut mucosal blood flow and delays the metabolic acidosis due to intestinal ischemia in the presence of a decreased perfusion pressure [21][22] . The beneficial effect of EA has been attributed to a sympathetic nerve blockade, which redistributes blood flow to the non-perfused regions of the gut [21] .…”

Thoracic epidural anesthesia: Effects on splanchnic circulation and implications in Anesthesia and Intensive care

“…Volume loading could not modify macrohemodynamic parameters but significantly reduced portal venous oxygen content. Ai et al [6] considered an animal model of systemic hypoxemia, finding that epidural blockade produced higher intramucosal and arterial pH, lower portal endotoxin and lower arterial lactate levels when compared to a control group. Portal blood flow re mained stable during progressive hypoxia and was unaffected by epidural blockade.…”

“…The six studies using surrogate hemodynamic parameters had conflicting results. Tanaka et al [23] used PDRicg as indirect measure of hepatic blood [7] Hogan et al [8] Sielenkämper et al [10] Adolphs et al [12] Adolphs et al [11] Schwarte et al [15] Kosugi et al [9] Freise et al [13] Daudel et al [14] Bachmann et al [16] Tanaka et al [23] Väisänen et al [25] Spackman et al [26] Gould et al [20] Michelet et al [22] Kortgen et al [27] Meierhenrich et al [21] Trepenaitis et al [24] Treatment Meissner et al [4] Ai et al [6] Vagts et al [5] Shäper et al [3] Freise et al [17] Freise et al [18] Treatment allocation Siniscalchi A et al . Thoracic epidural anesthesia flow, finding that TEA reduced blood flow to the liver, fluid resuscitation alone could not reverse this effect but had to be associated with dopamine infusion.…”

Evaluation of Sympathetic Blockade after Intrathecal and Epidural Lidocaine in Rats by Laser Doppler Perfusion Imaging

“…Furthermore, the extent of the sympathetic blockade is often solely demonstrated by a decrease in cardiac sympathetic outfl ow [3,5] , motor blockade of hind limbs [1,6] or (epidural) spread of dye [2,7] . The most accurate method to prove regional sympathetic block is by measuring efferent neuronal activity [8] , which requires direct access to neuronal structures, sophisticated technical equipment and expertise.…”