Background: Because it is postulated that gut is important via bacterial tr
anslocation in the development of the systemic inflammatory response and mu
ltiple organ dysfunction, the preservation of gut integrity is a therapeuti
c goal for physicians who care for critically ill patients. The aim of the
current study was to evaluate whether epidural anesthesia prevented gut inj
ury and subsequent translocation of endotoxin during acute progressive hypo
xia in rabbits.
Methods: After the placement of an epidural catheter, 18 male rabbits, anes
thetized with buprenorphine-midazolam, were allocated randomly to two group
s: 0.5% lidocaine (group E) and saline (group C) groups. The solutions (0.4
ml/kg) were injected epidurally, followed by continuous infusion (0.1 ml.k
g(-1).h(-1)) during the study period. Portal blood flow, portal endotoxin c
oncentrations, and intramucosal pH (pHi) of the ileum were measured at base
line and during two stages of progressive hypoxia (fraction of inspired oxy
gen [FIO2] = 0.15 and 0.10),
Results: In both study groups, the portal blood flow was preserved to a sim
ilar extent during acute hypoxia. However, pHi was reduced to a lesser exte
nt in group E (7.33 +/- 0.12 versus 7.22 +/- 0.12 at an FIO2 of 0.15 and 7.
13 +/- 0.15 versus 7.03 +/- 0.12 at an FIO2 of 0.10; mean +/- SD, P < 0.01)
, concurrently with lower portal endotoxin concentrations (P < 0.05) compar
ed with group C.
Conclusions: The current study showed that epidural anesthesia slowed the p
rogression of intestinal ischemia during acute hypoxia, subsequently preven
ting translocation of endotoxin through the sit mucosa.