Hemodynamic effects of thoracic epidural analgesia in ovine hyperdynamic endotoxemia.

Hemodynamic effects of thoracic epidural analgesia in ovine hyperdynamic endotoxemia. Research Abstract Details 

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Hemodynamic effects of thoracic epidural analgesia in ovine hyperdynamic endotoxemia. Abstract Text:

Fritz Daudel,Christian Ertmer,Henning D Stubbe,Matthias Lange,Rafael Pulina,Hans-Georg Bone,Andreas W ,Hugo Van Aken,Martin Westphal,Fritz Daudel,Christian Ertmer,Henning D Stubbe,Matthias Lange,Rafael Pulina,Hans-Georg Bone,Andreas W ,Hugo Van Aken,Martin Westphal,

BACKGROUND AND OBJECTIVES: Thoracic epidural analgesia (TEA) is increasingly used for perioperative analgesia. If patients with TEA develop sepsis or systemic inflammatory response subsequent to extended surgery the question arises if it would be safe to continue TEA with its beneficial effects of improving gastrointestinal perfusion and augmenting tissue oxygenation. A major concern in this regard is hemodynamic instability that might ensue from TEA-induced vasodilation. The objective of the present study was to assess the effects of TEA on systemic and pulmonary hemodynamics in a sepsis model of hyperdynamic endotoxemia. METHODS: After a baseline measurement in healthy sheep (n = 14), Salmonella thyphosa endotoxin was continuously infused at a rate of 10 ngxkg(-1)xmin(-1) over 16 hours. The surviving animals (n = 12) were then randomly assigned to 1 of 2 study groups. In the treatment group (n = 6), continuous TEA was initiated with 0.1 mLxkg(-1) bupivacaine 0.125% and maintained with 0.1 mLxkg(-1)xh(-1). In the control group (n = 6) the same amount of isotonic sodium saline solution was injected at the same rate through the epidural catheter. RESULTS: In both experimental groups cardiac index increased and systemic vascular resistance decreased concurrently (each P < .05). Functional epidural blockade in the TEA group was confirmed by sustained suppression of the cutaneous (or panniculus) reflex. During the observational period of 6 hours neither systemic nor pulmonary circulatory variables were impaired by TEA. CONCLUSIONS: From a hemodynamic point of view, TEA presents as a safe treatment option in sepsis or systemic inflammatory response syndrome.

Hemodynamic effects of thoracic epidural analgesia in ovine hyperdynamic endotoxemia. Publishing Authors By Initials

F Daudel,C Ertmer,HD Stubbe,M Lange,R Pulina,HG Bone,AW ,H Van Aken,M Westphal,F Daudel,C Ertmer,HD Stubbe,M Lange,R Pulina,HG Bone,AW ,H Van Aken,M Westphal,

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Hemodynamic effects of thoracic epidural analgesia in ovine hyperdynamic endotoxemia. Journal Published:

PUBLICATION TYPE: Research Support, Non-U.S. Gov

Journal: Regional anesthesia and pain medicine

VOLUME: 32

Page Numbers: 311-6

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ISSN: 1098-7339

DAY: 27

MONTH: 08

YEAR: 2007

Hemodynamic effects of thoracic epidural analgesia in ovine hyperdynamic endotoxemia. Information

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LANGUAGE: eng

NlmUniqueID: 9804508

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Grant and Affiliation Information for Hemodynamic effects of thoracic epidural analgesia in ovine hyperdynamic endotoxemia.

AFFILIATION: Department of Intensive Care Medicine, University Hospital of Bern, Bern, Switzerland. fritz.daudel@insel.ch

Country: United States

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MEDLINETA: Reg Anesth Pain Med

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