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首页> 外文期刊>World Journal of Gastroenterology >Epidural anaesthesia restores pancreatic microcirculation and decreases the severity of acute pancreatitis.
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Epidural anaesthesia restores pancreatic microcirculation and decreases the severity of acute pancreatitis.

机译：硬膜外麻醉可恢复胰腺微循环并降低急性胰腺炎的严重程度。

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AIM:To investigate the effect of epidural anaesthesia (EA) on pancreatic microcirculation during acute pancreatitis (AP).METHODS:AP was induced by injection of sodium taurocholate into the pancreatic duct of Sprague-Dawley rats. To realize EA, a catheter was introduced into the epidural space between T7 and T9 and bupivacaine was injected. Microcirculatory flow was measured by laser Doppler flowmetry. Arterial blood gas analyses were performed. At the end of the experiment (<= 5 h), pancreas was removed for histology. The animals were divided into three groups: Group 1 (n=9), AP without EA; Group 2 (n=4), EA without AP; and Group 3 (n=6), AP treated by EA.RESULTS:In Group 1, pancreatic microcirculatory flow prior to AP was 141+/- 39 perfusion units (PU). After AP, microcirculatory flow obviously decreased to 9+/- 6 PU (P<0.05). Metabolic acidosis developed with base excess (BE) of - 14+/- 3 mmol/L. Histology revealed extensive edema and tissue necrosis. In Group 2, EA did not significantly modify microcirculatory flow. BE remained unchanged and histological analysis showed normal pancreatic tissue. In Group 3, AP initially caused a significant decrease in microcirculatory flow from 155+/- 25 to 11+/- 7 PU (P<0.05). After initiation of EA, microcirculatory flow obviously increased again to 81+/- 31 PU (P<0.05). BE was -6+/- 4 mmol/L, which was significantly different compared to Group 1 (P<0.05). Furthermore, histology revealed less extensive edema and necrosis in pancreatic tissue in Group 3 than that in Group 1.CONCLUSION:AP caused dramatic microcirculatory changes within the pancreas, with development of metabolic acidosis and tissue necrosis. EA allowed partial restoration of microcirculatory flow and prevented development of tissue necrosis and systemic complications. Therefore, EA should be considered as therapeutic option to prevent evolution from edematous to necrotic AP.
机译：目的：探讨硬膜外麻醉（EA）对急性胰腺炎（AP）过程中胰腺微循环的影响。方法：通过向Sprague-Dawley大鼠的胰管中注射牛磺胆酸钠来诱导AP。为了实现EA，将导管插入T7和T9之间的硬膜外腔，并注射布比卡因。通过激光多普勒血流仪测量微循环流量。进行了动脉血气分析。实验结束时（<= 5小时），取出胰腺进行组织学检查。将动物分为三组：第1组（n ＝ 9），无EA的AP；和无EA的AP。第2组（n = 4），没有AP的EA；结果：在第1组中，AP之前的胰腺微循环流量为141 +/- 39灌注单位（PU）。 AP后，微循环流量明显下降至9 +/- 6 PU（P <0.05）。代谢性酸中毒的基础过量（BE）为-14 +/- 3 mmol / L。组织学显示广泛的水肿和组织坏死。在第2组中，EA并未显着改变微循环流量。 BE保持不变并且组织学分析显示正常胰腺组织。在第3组中，AP最初导致微循环流量从155 +/- 25 PU显着下降至11 +/- 7 PU（P <0.05）。 EA启动后，微循环流量明显增加至81 +/- 31 PU（P <0.05）。 BE为-6 +/- 4 mmol / L，与第1组相比有显着差异（P <0.05）。此外，组织学检查显示第3组的胰腺组织水肿和坏死程度低于第1组。结论：AP引起胰腺内微循环的急剧变化，并伴有代谢性酸中毒和组织坏死的发展。 EA可部分恢复微循环血流，并防止组织坏死和全身并发症的发生。因此，EA应被视为防止从水肿性AP发展为坏死性AP的治疗选择。

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