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Anaesthesia and splanchnic perfusion

  • N. Požar Lukanović
Conference paper

Abstract

Despite advances in anaesthesia and intensive care, organ failure remains one of the common causes of postoperative morbidity and mortality [1].

Keywords

Corticotropin Release Factor Major Abdominal Surgery Thoracic Epidural Anaesthesia Splanchnic Perfusion Hypoxic Damage 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Mythen MG, Webb AR (1994) The role of gut mucosal hypoperfusion in the pathogenesis of post-operative organ dysfunction. Intensive Care Med 20:203–209Google Scholar
  2. 2.
    Van Aken H, Rolf N (1999) Thoracic epidural anaesthesia. Baillieres Clin Anesthesiol 13: 10–107Google Scholar
  3. 3.
    Peyton PJ, Myles PS, Silbert BS et al (2003) Perioperative epidural analgesia and outcome after major abdominal surgery in high-risk patients. Anest Analg Feb 96 (2): 548–554Google Scholar
  4. 4.
    Adeau A, Newell P, Dobbs BR et al (2002) Postoperative epidural analgesia following elective major abdominal surgery in high risk patients: a retrospective cohort study. N Z Med J 115: 69–72Google Scholar
  5. 5.
    Rigg JR, Jamrozik K, Myles PS et al (2002) Epidural anaesthesia and analgesia and outcome of major surgery: a randomised trial. Lancet, Apr 13;359(9314): 1276–1282CrossRefGoogle Scholar
  6. 6.
    Holte K, Kehlet H (2002) Effect of postoperative epidural analgesia on surgical outcome. Minerva Anestesiol Apr; 68 (4): 157–161Google Scholar
  7. 7.
    Rodgers A, Walker N, Schug S et al (2000) Reduction of postoperative morbidity and mortality with epidural or spinal anaesthesia: results from an overview of randomised trials. BJM 321: 1493–1497CrossRefGoogle Scholar
  8. 8.
    Lundgreen 0 (1989) Physiology of the intestinal circulation. In: Marston A, Bukley GB, Fiddian-Green RG, Haglund UH (eds) Splanchnic ischemia and multiple organ failure. Edvard Arnold, London, pp 29–40Google Scholar
  9. 9.
    Fink MP (1991) Why the GI tract is pivotal in trauma sepsis and MOF. Crit Ilness 6: 253–276Google Scholar
  10. 10.
    Neutra MR, Padykula HA (1984) The gastrointestinal tract. In: Weiss I (ed) Modern concepts of gastrointestinal histology, 2nd edn. Elsevier, New York Amsterdam Oxford, pp 659–705Google Scholar
  11. 11.
    Lautt WW, Legare DJ, d’Almeida MS (1985) Adenosine as a putative regulator of hepatic arterial flow (the buffer response). Am J Phisiol 248: H331–338Google Scholar
  12. 12.
    Brinkmann A, Calzia E, Trager K, Rademacher P (1998) Monitoring the hepato-splanchnic region in the critically ill patient. Intensive Care Med 24: 542–556PubMedCrossRefGoogle Scholar
  13. 13.
    Gelman S (1976) Disturbances in hepatic blood flow during anesthesia and surgery. Arceh Surg 111: 881–883CrossRefGoogle Scholar
  14. 14.
    Dahn MS, Lange P, Lobodell K, Hans B et al (1987) Splanchnic and total body oxygen consumption differences in septic and injured patient. Surgery 101: 69–80PubMedGoogle Scholar
  15. 15.
    Greene NM, Brull SJ (1993) Haemodynamic effects of spinal anaesthesia In: Physiology of spinal anaesthesia, 4th edn. Williams liu Wilkins, BaltimoreGoogle Scholar
  16. 16.
    Mythen MG, Barclay GR, Browne DA et al (1992) Endogenous anti-endotoxin-core antibodyes, gut mucosal perfusion and postoperative MODS. Int Care Med 18: S57CrossRefGoogle Scholar
  17. 17.
    Kirton OC, Civetta JM (1997) Splanchnic flow and resuscitation. In: Civetta JM, Taylor RW, Kirby RR (eds) Critical care, 3rd edn. Philadelphia, Lippincot-Raven 443–455Google Scholar
  18. 18.
    Weismann C (1990) The metabolic response to stress: an overview and update. Anesthesiology 73: 308–328CrossRefGoogle Scholar
  19. 19.
    Roizen MF, Lampe GH, Benefiel DJ et al (1987) Is increased operative stress associated with worse outcome? Anesthesiology 67: A1CrossRefGoogle Scholar
  20. 20.
    Kehlet H (1998) Modification of stress response to surgery by neural blockade: clinical implications. In: Cousins MJ, Bridenbough PQ (eds.) Neural blockade in clinical anesthesia and management of pain, Philadelphia, Lippincot-Raven, pp 129–175Google Scholar
  21. 21.
    Brandt MR, Korshin J, Prange-Hansen A et al (1978) Influence of morphine anaesthesia on the endocrine-metabolic response to open-heart surgery. Acta Anaesth Scand 31: 243–247Google Scholar
  22. 22.
    Walsh ES, Paterson JL, O’ Riordan JBA, Hall GM (1981) Effect of high-dose fentanyl anaesthesia on the metabolic and endocrine response to cardiac surgery. Br J Anaesth 53: 1155–1165PubMedCrossRefGoogle Scholar
  23. 23.
    Reyes JG, Karp RB, Buttner et al (1982) Neuronal and adrenomedullary cathecholamine release in response to cardiopulmonary bypass in man. Circulation 66: 49–55CrossRefGoogle Scholar
  24. 24.
    Acosta F, Diaz J, Moreno J et al (1995) Relationship between 1-endorphin release and surgical stress in orthotopic liver transplantation. Transplant Proc 27: 2303PubMedGoogle Scholar
  25. 25.
    Hortgson PS (1999) Thoracic epidural anaesthesia and analgesia for abdominal surgery: effects on gastrointestinal function and perfusion. Baillieres Clin Anaesthesiol 13: 9–22Google Scholar
  26. 26.
    Sutcliffe NP, Mostafa SM, Gannon J, Harper SJ (1996) The effect of epidural blockade on gastric intramucosal pH in the peri-operative period Anaesthesia. Jul; 5I (7): 711Google Scholar
  27. 27.
    Beattie WS, Badner N, Choi P (2001) Epidural analgesia reduces postoperative myocardial infarction: a meta-analysis. Anesth Analg 93: 853–858PubMedCrossRefGoogle Scholar
  28. 28.
    Buggy DY, Doherty WL, Hart EM, Pallett EJ (2002) Postoperative wound oxygen tension with epidural or intravenous analgesia: a prospective, randomised, single —blinded clinical trial. Anesthesiology 98: 952–958CrossRefGoogle Scholar
  29. 29.
    Sielenkamper AW, Eicker K, Van Aken H (2000) Thoracic epidural anesthesia increases mucosal perfusion of rats. Anesthesiology 93: 844–851PubMedCrossRefGoogle Scholar
  30. 30.
    Adolphs J, Schmidt DK, Mousa SA et al (2003) Thoracic epidural anesthesia attenuates hemorrhage-induced impairment of intestinal perfusion in rats. Anesthesiology 99: 685–692PubMedCrossRefGoogle Scholar
  31. 31.
    Ai K, Kotake Y, Satoh T (2001) Epidural anesthesia retards intestinal acidosis and reduces portal vein endotoxin concentrations during progressive hypoxia in rabbits. Anesthesiology 94: 263–269PubMedCrossRefGoogle Scholar
  32. 32.
    Johansson K, Ahn H, Lindhagen J et al (1988) Effects of epidural anaesthesia on intestinal blood flow. Br J Anaesth 75: 73–76Google Scholar
  33. 33.
    Vaisanen O, Parvianen I, Roukonen E et al (1998) Epidural analgesia with 5% bupivacaine does not improve splanchnic tissue perfusion after aortic reconstruction surgery. Br J Anaesth 81: 893–898PubMedCrossRefGoogle Scholar
  34. 34.
    Mallinder PA, Hall JE, Bergin FG et al (2000) A comparison of opiate-and epidural-induced alterations in splanchnic blood flow using intra-operative gastric tonometry. Anesthesia 55: 659–665CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia, Milano 2004

Authors and Affiliations

  • N. Požar Lukanović

There are no affiliations available

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