Epidural anesthesia retards intestinal acidosis and reduces portal vein endotoxin concentrations during progressive hypoxia in rabbits

Citation
K. Ai et al., Epidural anesthesia retards intestinal acidosis and reduces portal vein endotoxin concentrations during progressive hypoxia in rabbits, ANESTHESIOL, 94(2), 2001, pp. 263-269
Citations number
36
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Aneshtesia & Intensive Care","Medical Research Diagnosis & Treatment
Journal title
ANESTHESIOLOGY
ISSN journal
0003-3022 → ACNP
Volume
94
Issue
2
Year of publication
2001
Pages
263 - 269
Database
ISI
SICI code
0003-3022(200102)94:2<263:EARIAA>2.0.ZU;2-T
Abstract
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.