title: Effect of epidural anesthesia on anastomotic leakage in colonic surgery: experimental study.
abstract: BACKGROUND
  The association between the infusion of continuous epidural anesthesia and the anastomotic strength of colonic anastomosis was examined in an animal model.
  
  
  METHODS
  Fourteen white male New Zealand rabbits were included in the study and randomly assigned to two groups. Group 1 (n=7) had continuous epidural 0.9% NaCl infusion (0.4 ml kg-1 bolus and 0.2 ml kg-1 h-1 infusion) and Group 2 (n=7) had continuous epidural 1% lidocaine infusion (0.4 ml kg-1 bolus and 0.2 ml kg-1 h-1 infusion). Infusions started at the beginning of the operation and were continued for six hours postoperatively. All experimental animals underwent right colon resection and colo-colonic anastomosis under general anesthesia. On the fourth postoperative day, relaparotomy was applied and the bursting pressures of the anastomosis (BPA) were measured in situ. Segments 1-cm long consisting of the complete suture lines were excised, and the levels of hydroxyproline and collagen were measured.
  
  
  RESULTS
  BPAs were statistically higher in the epidural lidocaine group (median: 248 mmHg; min 117 - max 300) than in the saline group (median: 109 mmHg; min 47 - max 176) (p=0.006). There was no difference between the groups in terms of hydroxyproline and collagen levels in the sample tissues (p>0.05).
  
  
  CONCLUSIONS
  We concluded that the strength of colonic anastomosis may be increased by epidural lidocaine infusion.
authors.affiliation: Department of Anesthesiology and Reanimation, Atatürk Training and Research Hospital, İzmir, Turkey. tayfunadanir@gmail.com
authors.forename: Tayfun
authors.initials: T
authors.lastname: Adanır
authors.forename: Murat
authors.initials: M
authors.lastname: Aksun
authors.forename: Gülşah
authors.initials: G
authors.lastname: Yılmaz Karaören
authors.forename: Türker
authors.initials: T
authors.lastname: Karabuğa
authors.forename: Okay
authors.initials: O
authors.lastname: Nazlı
authors.forename: Atilla
authors.initials: A
authors.lastname: Sencan
authors.forename: Mehmet
authors.initials: M
authors.lastname: Köseoğlu
mesh_terms: D000714:Anastomosis, Surgical; D057868:Anastomotic Leak; D000767:Anesthesia, Epidural; D000779:Anesthetics, Local / Q000008:administration & dosage*; D000818:Animals; D003108:Colonic Diseases / Q000601:surgery*; D004195:Disease Models, Animal; D010535:Laparoscopy; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D011183:Postoperative Complications; D011817:Rabbits; D014945:Wound Healing
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine