Effects of thoracic epidural anesthesia on hemodynamics and global oxygen transport in ovine endotoxemia

Daudel, Fritz; Bone, Hans-Georg; Traber, Daniel L; Stubbe, Henning D; Lettau, Martin; Lange, Matthias; Scharte, Marion; Van Aken, Hugo; Westphal, Martin (2006). Effects of thoracic epidural anesthesia on hemodynamics and global oxygen transport in ovine endotoxemia. Shock, 26(6), pp. 615-9. Hagerstown, Md.: Lippincott Williams & Wilkins 10.1097/01.shk.0000228799.25797.fb

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Besides providing effective analgesia, thoracic epidural anesthesia (TEA) has been shown to decrease perioperative morbidity and mortality. Because of its vasodilatory properties in association with the sympathetic blockade, however, TEA may potentially aggravate cardiovascular dysfunctions resulting from sepsis and systemic inflammatory response syndrome. The objective of the present study was to assess the effects of TEA on hemodynamics, global oxygen transport, and renal function in ovine endotoxemia. After a baseline measurement in healthy sheep (n = 18), Salmonella typhosa endotoxin was centrally infused at incremental doses to induce and maintain a hypotensive-hypodynamic circulation using an established protocol. The animals were then randomly assigned to one of two groups. In the treatment group, continuous TEA was initiated with 0.1 mL.kg of 0.125% bupivacaine at the onset of endotoxemia and maintained with 0.1 mL.kg.h. In the control group, the same amount of isotonic sodium chloride solution was injected through the epidural catheter. In the animals surviving the entire experiment (n = 7 per group), cardiac index and mean arterial pressure decreased in a dose-dependent manner during endotoxin infusion. In the TEA group, neither systemic hemodynamics nor global oxygen transport were impaired beyond the changes caused by endotoxemia itself. Urinary output was increased in the TEA group as compared with the control group (P < 0.05). In this model of endotoxic shock, TEA improved renal perfusion without affecting cardiopulmonary hemodynamics and global oxygen transport.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care

UniBE Contributor:

Daudel, Fritz

ISSN:

1073-2322

ISBN:

17117138

Publisher:

Lippincott Williams & Wilkins

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:48

Last Modified:

17 Mar 2015 21:48

Publisher DOI:

10.1097/01.shk.0000228799.25797.fb

PubMed ID:

17117138

Web of Science ID:

000242466300014

URI:

https://boris.unibe.ch/id/eprint/19951 (FactScience: 3029)

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