Document Detail


Effects of thoracic epidural anaesthesia on intestinal microvascular perfusion in a rodent model of normotensive endotoxaemia.
MedLine Citation:
PMID:  15338125     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate whether sympathetic blockade by means of thoracic epidural anaesthesia (TEA) increases intestinal perfusion during normotensive endotoxaemia. DESIGN: A prospective, randomised and controlled animal study. SETTING: Animal laboratory in a university hospital. SUBJECTS: Sprague-Dawley male rats. INTERVENTIONS: The rats were anaesthetised with urethane and ketamine, mechanically ventilated and haemodynamically monitored. Lidocaine or saline were infused continuously via thoracic epidural catheters followed by a continuous intravenous infusion of Escherichia coli lipopolysaccharide (1.5 mg/kg per h). Densities of perfused and non-perfused capillaries (i.e., with and without erythrocyte perfusion, respectively) as well as erythrocyte velocity in both the mucosa and the muscularis of the terminal ileum were determined using intravital microscopy. MEASUREMENTS AND RESULTS: Measurements were performed at baseline, after 30 min of epidural infusion as well as after 60 and 120 min of lipopolysaccharide infusion. In animals receiving TEA, mean arterial pressure and heart rate were significantly reduced throughout the experiment. In the muscularis the endotoxaemia-induced increase in non-perfused capillaries was absent with epidural lidocaine (0 [0/0] versus 39 [36/137] cm(-1), median [25(th)/75(th) percentile]), whereas in the mucosa perfused capillary density declined to a greater extent than in controls (-47 [-53/-23]%) versus -19 [-34/+10]%, p<0.05). Erythrocyte velocity decreased with endotoxaemia and was not influenced by epidural lidocaine. CONCLUSIONS: Microvascular perfusion data during endotoxaemia show a redistribution of blood flow towards the mucosa. TEA seems to impede this redistribution resulting in improved muscularis and worsened mucosal microvascular perfusion.
Authors:
Jörn Adolphs; Diego K Schmidt; Ines Korsukewitz; Britta Kamin; Helmut Habazettl; Michael Schäfer; Martin Welte
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Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2004-08-26
Journal Detail:
Title:  Intensive care medicine     Volume:  30     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2004 Nov 
Date Detail:
Created Date:  2004-11-19     Completed Date:  2005-03-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2094-101     Citation Subset:  IM    
Affiliation:
Department of Anaesthesiology and Critical Care Medicine, Campus Benjamin Franklin, Charité-Universitätsmedizin Berlin, Hindenburgdamm 30, 12200 Berlin, Germany. joern.adolphs@charite.de
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MeSH Terms
Descriptor/Qualifier:
Anesthesia, Epidural*
Animals
Autonomic Nerve Block*
Intestinal Mucosa / blood supply*,  drug effects
Intestines / blood supply*,  drug effects
Lipopolysaccharides
Male
Microcirculation / drug effects
Prospective Studies
Random Allocation
Rats
Rats, Sprague-Dawley
Regional Blood Flow / drug effects
Sepsis* / physiopathology
Statistics, Nonparametric
Thoracic Vertebrae
Chemical
Reg. No./Substance:
0/Lipopolysaccharides
Comments/Corrections
Comment In:
Intensive Care Med. 2004 Nov;30(11):1987-9   [PMID:  15448890 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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