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Thoracic epidural anaesthesia reduces insulin resistance and inflammatory response in experimental acute pancreatitis
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Anaesthesiology.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Anaesthesiology.
Umeå University, Faculty of Medicine, Department of Medical Biosciences, Pathology.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Anaesthesiology.
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2018 (English)In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967Article in journal (Refereed) Epub ahead of print
Abstract [en]

AIMS: The activity of the sympathetic nervous system (SNS) is crucial at an early stage in the development of an inflammatory reaction. A study of metabolic events globally and locally in the early phase of acute pancreatitis (AP), implying hampered SNS activity, is lacking. We hypothesized that thoracic epidural anaesthesia (TEA) modulates the inflammatory response and alleviates the severity of AP in pigs.

MATERIAL AND METHODS: The taurocholate (TC) group (n = 8) had only TC AP. The TC + TEA group (n = 8) had AP and TEA. A control group (n = 8) underwent all the preparations, without having AP or TEA. Metabolic changes in the pancreas were evaluated by microdialysis and by histopathological examination.

RESULTS: The relative increase in serum lipase concentrations was more pronounced in the TC group than in TC + TEA and control groups. A decrease in relative tissue oxygen tension (PtiO2) levels occurred one hour later in the TC + TEA group than in the TC group. The maintenance of normoglycaemia in the TC group required a higher glucose infusion rate than in the TC + TEA group. The relative decrease in serum insulin concentrations was most pronounced in the TC + TEA group.

CONCLUSION: TEA attenuates the development of AP, as indicated by changes observed in haemodynamic parameters and by the easier maintenance of glucose homeostasis. Further, TEA was associated with attenuated insulin resistance and fewer local pathophysiological events.

Place, publisher, year, edition, pages
Taylor & Francis, 2018.
Keywords [en]
Acute pancreatitis, epidural anaesthesia, insulin, microdialysis, sodium-taurocholic acid, sympathetic nervous system
National Category
Anesthesiology and Intensive Care Surgery
Identifiers
URN: urn:nbn:se:umu:diva-153672DOI: 10.1080/03009734.2018.1539054PubMedID: 30468105OAI: oai:DiVA.org:umu-153672DiVA, id: diva2:1265821
Available from: 2018-11-26 Created: 2018-11-26 Last updated: 2018-12-11

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Winsö, OlaKral, JosefWang, WanzhongKralova, IvanaAbrahamsson, PernillaJohansson, GöranBlind, Per-Jonas

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