title: Thoracic epidural analgesia reduces gastric microcirculation in the pig.
abstract: Thoracic epidural analgesia (TEA) is used for pain relief during and after abdominal surgery, but the effect of TEA on the splanchnic microcirculation remains debated. We evaluated whether TEA affects splanchnic microcirculation in the pig.
  
  
  
  Splanchnic microcirculation was assessed in nine pigs prior to and 15 and 30 min after induction of TEA. Regional blood flow was assessed by neutron activated microspheres and changes in microcirculation by laser speckle contrast imaging (LSCI).
  
  
  
  As assessed by LSCI 15 min following TEA, gastric arteriolar flow decreased by 22 % at the antrum (p = 0.020) and by 19 % at the corpus (p = 0.029) of the stomach. In parallel, the microcirculation decreased by 19 % at the antrum (p = 0.015) and by 20 % at the corpus (p = 0.028). Reduced arteriolar flow and microcirculation at the antrum was confirmed by a reduction in microsphere assessed regional blood flow 30 min following induction of TEA (p = 0.048). These manifestations took place along with a drop in systolic blood pressure (p = 0.030), but with no significant change in mean arterial pressure, cardiac output, or heart rate.
  
  
  
  The results indicate that TEA may have an adverse effect on gastric arteriolar blood flow and microcirculation. LSCI is a non-touch technique and displays changes in blood flow in real-time and may be important for further evaluation of the concern regarding the effect of thoracic epidural anesthesia on gastric microcirculation in humans.
  
  
  
  Not applicable, non-human study.
authors.affiliation: Department of Surgical Gastroenterology C, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK - 2100, Copenhagen Ø, Denmark. riam@dadlnet.dk.
authors.forename: Rikard
authors.identifier: 0000-0001-9342-8871
authors.initials: R
authors.lastname: Ambrus
authors.affiliation: Department of Surgical Gastroenterology C, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK - 2100, Copenhagen Ø, Denmark.
authors.forename: Rune B
authors.initials: RB
authors.lastname: Strandby
authors.affiliation: Department of Anesthesiology 2041, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK - 2100, Copenhagen Ø, Denmark.
authors.forename: Niels H
authors.initials: NH
authors.lastname: Secher
authors.affiliation: Department of Anesthesiology 2041, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK - 2100, Copenhagen Ø, Denmark.
authors.forename: Kim
authors.initials: K
authors.lastname: Rünitz
authors.affiliation: Marine Biological Section, University of Copenhagen, Strandpromenaden 5, DK - 3000, Elsinore, Denmark.
authors.forename: Morten B S
authors.initials: MB
authors.lastname: Svendsen
authors.affiliation: Department of Anesthesiology 2041, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK - 2100, Copenhagen Ø, Denmark.
authors.forename: Lonnie G
authors.initials: LG
authors.lastname: Petersen
authors.affiliation: Department of Surgical Gastroenterology C, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK - 2100, Copenhagen Ø, Denmark.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Achiam
authors.affiliation: Department of Surgical Gastroenterology C, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK - 2100, Copenhagen Ø, Denmark.
authors.forename: Lars B
authors.initials: LB
authors.lastname: Svendsen
mesh_terms: D015360:Analgesia, Epidural / Q000379:methods*; D000818:Animals; D001794:Blood Pressure / Q000187:drug effects; D002302:Cardiac Output / Q000187:drug effects; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D008833:Microcirculation / Q000187:drug effects*; D012039:Regional Blood Flow / Q000187:drug effects*; D013152:Splanchnic Circulation / Q000187:drug effects*; D013552:Swine; D013904:Thoracic Vertebrae; D013997:Time Factors
keywords: Laser speckle contrast imaging; Pigs; Splanchnic microcirculation; Thoracic epidural analgesia