Systemic and Regional Blood Flow during Epidural Anesthesia without Epinephrine in the Rhesus Monkey

Sivarajan, Murali; Amory, David W.; Lindbloom, Leo E.

doi:10.1097/00000542-197609000-00010

Cited by 33 publications

(14 citation statements)

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“…However the mechanism appears to be more complex and other mediators could be involved [40] . The studies evaluating the effects of TEA on liver macro hemodynamics in normal conditions, found no difference [5] , or a reduction [2] , in total hepatic blood flow. It must be noted that, when comparing the results of these two studies, the extension of epidural blockade could have influenced the outcome.…”

Section: Liver Circulationmentioning

confidence: 97%

“…The regional flow could be estimated by measuring organ or regional arterial blood samples radioactivity, or by microscopy after autopsy. Sivarajan et al [2] evaluated the effects of low (T10) and high (T1) epidural anesthesia on sys temic hemodynamics and regional blood flow in anesthetized monkeys. The main findings of this study were that both CO and arterial blood pressure significantly decreased in both groups and more significantly in the high epidural T1 group.…”

Section: Effects Of Epidural Anesthesia On Splanchnic Circulationmentioning

confidence: 99%

“…Studies focusing on regional macrohemodynamics in healthy animals [2,5] and humans undergoing elective surgery [1921,2325] demonstrated no influence or worsening of regional perfusion in subject receiving thoracic epidural anesthesia. On the other hand most of the studies focusing on microhemodynamics [712,17,18] , especially those focusing on pathologic low flow conditions, suggested that TEA could foster microcirculation despite a reduction in mean perfusion pressure.…”

Section: Splanchnic Circulation and Epidural Blockadementioning

confidence: 99%

“…It must be noted that, when comparing the results of these two studies, the extension of epidural blockade could have influenced the outcome. In fact Vagts et al [5] (cit) considered the effects of a T5T12 block, while Sivarajan et al [2] (cit) compared two levels of sensory blockade, finding a reduction of total hepatic blood flow only in the high level sensory blockade group (T1).…”

Section: Liver Circulationmentioning

confidence: 99%

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

Siniscalchi

Gamberini

Laici

et al. 2015

WJCCM

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AIM:To evaluate the currently available evidence on thoracic epidural anesthesia effects on splanchnic macro and microcirculation, in physiologic and pathologic conditions. METHODS:A PubMed search was conducted using the MeSH database. Anesthesia, Epidural was always the first MeSH heading and was combined by boolean operator AND with the following headings: Circulation, Splanchnic; Intestines; Pancreas and Pancreatitis; Liver Function Tests. EMBASE, Cochrane library, ClinicalTrials. gov and clinicaltrialsregister.eu were also searched using the same terms. RESULTS:Twenty-seven relevant studies and four ongoing trials were found. The data regarding the effects of epidural anesthesia on splanchnic perfusion are conflicting. The studies focusing on regional macro-hemodynamics in healthy animals and humans undergoing elective surgery, demonstrated no influence or worsening of regional perfusion in patients receiving thoracic epidural anesthesia (TEA). On the other hand most of the studies focusing on micro-hemodynamics, especially in pathologic low flow conditions, suggested that TEA could foster microcirculation. CONCLUSION:The available studies in this field are heterogeneous and the results conflicting, thus it is difficult to draw decisive conclusions. However there is increasing evidence deriving from animal studies, that thoracic epidural blockade could have an important role in modifying tissue microperfusion and protecting microcirculatory weak units from ischemic damage, regardless of the effects on macro-hemodynamics.

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Section: Liver Circulationmentioning

confidence: 97%

Section: Effects Of Epidural Anesthesia On Splanchnic Circulationmentioning

confidence: 99%

Section: Splanchnic Circulation and Epidural Blockadementioning

confidence: 99%

Section: Liver Circulationmentioning

confidence: 99%

See 2 more Smart Citations

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

Siniscalchi

Gamberini

Laici

et al. 2015

WJCCM

View full text Add to dashboard Cite

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“…Hypotension due to a decrease in systemic vascular resistance or cardiac output is a known side-effect of central neuraxial anaesthesia in animals and humans [3,5,15,16] . The magnitude and duration of hypotension were most distinct in the TEA10 and TEA30 groups and exceeded the values of LEA30 animals.…”

Section: Haemodynamic Parametersmentioning

confidence: 99%

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

Adolphs¹,

Schmitt

Schmidt³

et al. 2005

Eur Surg Res

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The widespread use of neuraxial anaesthesia increases the need for animal models to evaluate therapeutic prospects, mechanisms and risks of this technique. As a methodological prerequisite, we characterised the sympathetic blockade after different modes of neuraxial anaesthesia with regard to segments supplying the splanchnic region. Under haemodynamic monitoring, lidocaine 2% or saline were infused via intrathecal (10 µl), lumbar epidural (10 and 30 µl) or thoracic epidural (10 and 30 µl) catheters. Segmental spread of neuraxially infused local anaesthetic was assessed using methylene blue. Mean arterial blood pressure decreased more severely after neuraxial lidocaine in thoracic epidural (10 and 30 µl) compared to high-volume (30 µl) lumbar anaesthesia animals. Determination of the sympathetic blockade by means of laser Doppler perfusion imaging was restricted to the paws due to a higher density of subcutaneous blood vessels as compared to the abdominal wall (mean ± SD: 3.93 ± 0.06 vs. 1.35 ± 0.05/384 mm², p < 0.05). Only high-volume (30 µl) lumbar and thoracic epidural anaesthesia (10 and 30 µl) increased skin perfusion in both hind and front paws. This extensive sympathetic blockade was demonstrated to include splanchnic segments using thermography. Segmental spread of methylene blue did not closely correspond to laser Doppler findings and should be interpreted as minimum rather than exact epidural spread of local anaesthetic.

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Choice of Anesthesia

Graybar¹

1987

Anesthesia for Renal Transplantation

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Systemic and Regional Blood Flow during Epidural Anesthesia without Epinephrine in the Rhesus Monkey

Cited by 33 publications

References 0 publications

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

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

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

Choice of Anesthesia

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