title: Thoracic epidural bupivacaine attenuates inflammatory response, intestinal lipid peroxidation, oxidative injury, and mucosal apoptosis induced by mesenteric ischemia/reperfusion.
abstract: BACKGROUND
  We conducted this study to evaluate the effects of thoracic epidural anesthesia (TEA) on inflammatory response, lipid peroxidation, and oxidative stress in a rat model of mesenteric ischemia/reperfusion (I/R).
  
  
  METHODS
  Rats were divided into 4 groups: sham group (n=6; sham laparotomy), control group (n=6; I/R), bupivacaine group (n=6; mesenteric I/R and 20 μL/h 0.5% bupivacaine), and saline group (n=6, mesenteric I/R and 20 μL/h 0.9% saline). I/R injury was established by occluding the superior mesenteric artery for 1 hour followed by 12 hours reperfusion. Blood gas, tumor necrosis factor-α, interleukin-6, interleukin-1β, glutathione peroxidise, superoxide dismutase, catalese, myeloperoxidase concentrations, immunohistochemical examinations (intracellular adhesion molecule-1), apoptosis determination, and wet/dry ratio of intestinal edema were determined.
  
  
  RESULTS
  Bupivacaine significantly decreased the cytokine, malondialdehyde, and myeloperoxidase levels and increased the antioxidant enzyme levels. Wet/dry ratio comparison showed a significant decrease in the bupivacaine (2.88±0.17) group in comparison with control (5.45±0.67) and saline (5.87±0.17) groups. The intestinal injury score was significantly decreased in rats in the epidural bupivacaine (2 [1-2]) infusion group in comparison with rats in the control (3 [2-3]) and saline (3 [2-4]) groups. Bupivacaine (63%) caused a significant decrease in the percentage of apoptotic cells in comparison with control (85%) only. ICAM-1 levels in the bupivacaine (27.4±7.1) group decreased in comparison with control (12.3±7.4) and saline (24.9±3.2) groups.
  
  
  CONCLUSIONS
  This study demonstrated that epidural bupivacaine attenuates the mesenteric I/R-related inflammatory response and intestinal damage.
authors.affiliation: Gazi University, Medical Faculty, Department of Anesthesiology and Reanimation, Ankara, Turkey. nurbedirli@yahoo.com
authors.forename: Nurdan
authors.initials: N
authors.lastname: Bedirli
authors.forename: Nalan
authors.initials: N
authors.lastname: Akyürek
authors.forename: Omer
authors.initials: O
authors.lastname: Kurtipek
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kavutcu
authors.forename: Seyfi
authors.initials: S
authors.lastname: Kartal
authors.forename: Asli Cavunt
authors.initials: AC
authors.lastname: Bayraktar
mesh_terms: D000767:Anesthesia, Epidural; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D000818:Animals; D017209:Apoptosis / Q000187:drug effects*; D002045:Bupivacaine / Q000008:administration & dosage / Q000627:therapeutic use*; D002374:Catalase / Q000378:metabolism; D002404:Catheterization; D016207:Cytokines / Q000378:metabolism; D005979:Glutathione Peroxidase / Q000378:metabolism; D007150:Immunohistochemistry; D007249:Inflammation / Q000209:etiology / Q000517:prevention & control*; D018799:Intercellular Adhesion Molecule-1 / Q000378:metabolism; D007413:Intestinal Mucosa / Q000187:drug effects* / Q000378:metabolism*; D007422:Intestines / Q000187:drug effects; D015227:Lipid Peroxidation / Q000187:drug effects*; D008297:Male; D008315:Malondialdehyde / Q000378:metabolism; D017538:Mesenteric Artery, Superior / Q000502:physiology*; D018384:Oxidative Stress / Q000187:drug effects*; D009195:Peroxidase / Q000378:metabolism; D051381:Rats; D017208:Rats, Wistar; D015427:Reperfusion Injury / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D013482:Superoxide Dismutase / Q000378:metabolism; D013904:Thoracic Vertebrae
chemical_list: D000779:Anesthetics, Local; D016207:Cytokines; D018799:Intercellular Adhesion Molecule-1; D008315:Malondialdehyde; D002374:Catalase; D009195:Peroxidase; D005979:Glutathione Peroxidase; D013482:Superoxide Dismutase; D002045:Bupivacaine