title: Postoperative peridural analgesia increases the strength of colonic contractions without impairing anastomotic healing in rats.
abstract: OBJECTIVE
  Peridural analgesia (PDA) is a common treatment in postoperative management after abdominal surgery to shorten postoperative ileus and to permit early postoperative nutrition. There are conflicting opinions on the effect of early peristalsis on healing of colonic anastomoses.
  
  
  METHODS
  A short segment of the distal colon was resected in 32 Wistar rats. Two strain gauge transducers were placed on the serosa proximal to the anastomosis to measure the strength and periodicity of bowel contractions. A peridural catheter was placed between lumbar vertebra 7 and the sacral crest. The animals received 4, 16, 20, and 24 h after operation an injection of either 0.03 ml ropivacaine 0.75%/kg body weight or the same amount of sodium chloride (controls). After 3 and 10 days the colonic anastomoses were resected to measure the bursting pressure. The anastomoses were prepared for histopathological examination and determination of relative collagen content.
  
  
  RESULTS
  Postoperative PDA led to an increasing amplitude of phasic and tonic contractions while the frequency of contractions was not significantly affected. None of the groups presented with any anastomotic complications. The bursting pressure after 3 and 10 days was similar in the two groups. The relative amount of collagen I in the anastomotic area was significantly higher after treatment with peridural ropivacaine.
  
  
  CONCLUSIONS
  Postoperative PDA with ropivacaine increases the strength of colonic contractions. The increase in phasic contractions suggests a better propulsive bowel function. The significantly higher amount of collagen I in the anastomosis of animals in the PDA group supports the idea that healing of colonic anastomoses is improved rather than diminished by PDA.
authors.affiliation: Department of Surgery, Rhenish Westfalian Technical University, Pauwelsstrasse 30, 52057 Aachen, Germany. mjansen@ukaachen.de
authors.forename: Marc
authors.initials: M
authors.lastname: Jansen
authors.forename: Petra
authors.initials: P
authors.lastname: Lynen Jansen
authors.forename: Karsten
authors.initials: K
authors.lastname: Junge
authors.forename: Michael
authors.initials: M
authors.lastname: Anurov
authors.forename: Svetlana
authors.initials: S
authors.lastname: Titkova
authors.forename: Alexander
authors.initials: A
authors.lastname: Ottinger
authors.forename: Volker
authors.initials: V
authors.lastname: Schumpelick
mesh_terms: D000577:Amides / Q000494:pharmacology; D015360:Analgesia, Epidural; D000714:Anastomosis, Surgical; D000779:Anesthetics, Local / Q000494:pharmacology; D000818:Animals; D003106:Colon / Q000502:physiology* / Q000601:surgery*; D004195:Disease Models, Animal; D005769:Gastrointestinal Motility / Q000502:physiology*; D007551:Isotonic Contraction / Q000502:physiology; D011183:Postoperative Complications / Q000503:physiopathology* / Q000517:prevention & control*; D051381:Rats; D017208:Rats, Wistar; D000077212:Ropivacaine; D013997:Time Factors; D014945:Wound Healing / Q000502:physiology*
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine