The effects of epidural bupivacaine on ischemia/reperfusion-induced liver injury

Abstract

BACKGROUND: Several animal studies showed benefi cial effects of thoracic epidural anesthesia (TEA) in hippocampal, mesenteric and myocardial IR injury (2-4). In this study, we investigated the effects of epidural bupivacaine on hepatic ischemia reperfusion injury in a rat model. MATERIAL AND METHODS: Eighteen rats were randomly divided into three groups each containing 6 animals. The rats in Group C had sham laparotomy. The rats in the Group S were subjected to liver IR through laparotomy and 20 mcg/kg/h 0.9 % NaCl was administered to these rats via an epidural catheter. The rats in the Group B were subjected to liver IR and were given 20 mcg/kg/h bupivacaine via an epidural catheter. Liver tissue was harvested for MDA analysis, apoptosis and histopathological examination after 60 minutes of ischemia followed by 360 minutes of reperfusion. Blood samples were also collected for TNF-α, IL-1β, AST and ALT analysis. RESULTS: The AST and ALT levels were higher in ischemia and reperfusion group, which received only normal saline via the thoracic epidural catheter, compared to the sham group. In the ischemia reperfusion group, which received bupivacaine via the epidural catheter, IL-1 levels were signifi cantly higher than in the other groups. TNF-α levels were higher in the Groups S and B compared to the sham group. Bupivacaine administration induced apoptosis in all animals. CONCLUSION: These results showed that thoracic epidural bupivacaine was not a suitable agent for preventing infl ammatory response and lipid peroxidation in experimental hepatic IR injury in rats. Moreover, epidural bupivacaine triggered apoptosis in hepatocytes. Further research is needed as there are no studies in literature investigate the effects of epidural bupivacaine on hepatic ischemia reperfusion injury (Tab. 3, Fig. 3, Ref. 34). Text in PDF www.elis.sk.

Method of Direct Segmental Intra-hepatic Delivery Using a Rat Liver Hilar Clamp Model

“…There are a variety of potential modifications of the technique detailed here and some have previously been described in the literature. Depending on the model used molecules have been delivered using inhalation 11 , epidural infusion 12 , intraperitoneal injection 17 18 21 22 , intravenous administration 10 14 15 19 23 24 or injection into the peripheral superior mesenteric vein 8 .…”

“…The liver hilar clamp model in the rat provides a reproducible and stable platform for demonstrating hepatic ischemic-reperfusion injury. Variable hilar clamp models have been used by researchers to study the protective effects of anti-oxidants and other small molecules 6 7 8 9 10 11 12 13 14 . Points of variation include which vessels are clamped, which segment are made ischemic, whether or not the bile duct is included and the length of the period of reperfusion 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 .…”

“…Variable hilar clamp models have been used by researchers to study the protective effects of anti-oxidants and other small molecules 6 7 8 9 10 11 12 13 14 . Points of variation include which vessels are clamped, which segment are made ischemic, whether or not the bile duct is included and the length of the period of reperfusion 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 . Additionally, when this model is used to study the impact of administration of a molecule the route of administration is also heterogeneous 8 10 11 12 14 15 17 18 19 21 22 23 24 .…”

“…There are a variety of rat hilar clamp models currently in use. The most common is one in which the portal vein, hepatic artery and bile duct supplying the left lateral and median lobes are clamped using microsurgical clips 6 7 8 9 10 11 12 for 30 to 60 min 6 7 10 13 14 , and then a period of reperfusion from 60 min to 24 h 7 9 10 13 14 is allowed. The left lateral and median lobes of the rat liver comprise about 70% of the hepatic parenchyma 9 .…”

Evaluatıon of effects of bupıvacaıne and ısoflurane on pancreas damage after renal ıschemıa-reperfusıon ınjury: An experımental study

“…They reported that epidural bupivacaine administration did not prevent inflammatory response and lipid peroxidation in rat livers in the setting of hepatic I/R injury [13]. Lee et al proposed that continuous local anesthetic infusion worsened the renal damage in rats with renal I/R injury, and renal cell death and inflammatory changes were significantly more prominent in rats treated with local anesthesia [14].…”