[Effect of celiac plexus block and thoracic epidural block on arterial ketone body ratio].
We evaluated the effect of intraoperative celiac plexus block (CPB) and thoracic epidural block (TEB) on arterial ketone body ratio (AKBR) in the patients undergoing total or partial gastrectomy. Mean arterial pressure (MAP), heart rate, AKBR, and arterial blood gas were measured at the end of esophago-jejunostomy, gastro-duodenostomy, or gastro-jejunostomy (pre-block) and at the end of operation (post-block), respectively. After pre-block measurement, CPB with 99.5% ethanol 15-20 ml was carried out in 8 patients with advanced gastric cancer (CPB group); TEB with 2% lidocaine was performed on 8 patients (TEB group); and neither CPB nor TEB was done on 8 patients (control group). A significant reduction in MAP was observed after CPB and TEB. There was no difference in the degree of MAP decrease between CPB group and TEB group. No change in MAP was observed in control group. In CPB group significant decreases in AKBR, pH, and BE were induced by CPB. However, there were no difference in AKBR, pH, and BE between pre-block values and post-block values in TEB group as in the control group. These findings suggest that ethanol used in CPB reduces the redox state of hepatic mitochondria and increases lactate. Therefore we should pay attention to the changes in AKBR, pH, and BE after celiac plexus block with ethanol.
Hayakawa
J
J
Department of Anesthesia, Kanagawa Cancer Center Hospital, Yokohama.
Itoh
T
T
Kanemura
K
K
Shibata
T
T
Usuda
Y
Y
D000368:Aged; D015360:Analgesia, Epidural; D001340:Autonomic Nerve Block / Q000009:adverse effects; D002447:Celiac Plexus; D000431:Ethanol / Q000009:adverse effects; D005743:Gastrectomy; D006439:Hemodynamics; D006801:Humans; D007432:Intraoperative Period; D007657:Ketone Bodies / Q000097:blood*; D008297:Male; D008875:Middle Aged; D008930:Mitochondria, Liver / Q000378:metabolism
D007657:Ketone Bodies; D000431:Ethanol