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Thoracic epidural anesthesia decreases endotoxin-induced endothelial injury

Please always quote using this URN: urn:nbn:de:bvb:20-opus-116787
  • Background: The sympathetic nervous system is considered to modulate the endotoxin-induced activation of immune cells. Here we investigate whether thoracic epidural anesthesia with its regional symapathetic blocking effect alters endotoxin-induced leukocyte-endothelium activation and interaction with subsequent endothelial injury. Methods: Sprague Dawley rats were anesthetized, cannulated and hemodynamically monitored. E. coli lipopolysaccharide (Serotype 0127: B8, 1.5 mg x kg(-1) x h(-1)) or isotonic saline (controls) was infused for 300Background: The sympathetic nervous system is considered to modulate the endotoxin-induced activation of immune cells. Here we investigate whether thoracic epidural anesthesia with its regional symapathetic blocking effect alters endotoxin-induced leukocyte-endothelium activation and interaction with subsequent endothelial injury. Methods: Sprague Dawley rats were anesthetized, cannulated and hemodynamically monitored. E. coli lipopolysaccharide (Serotype 0127: B8, 1.5 mg x kg(-1) x h(-1)) or isotonic saline (controls) was infused for 300 minutes. An epidural catheter was inserted for continuous application of lidocaine or normal saline in endotoxemic animals and saline in controls. After 300 minutes we measured catecholamine and cytokine plasma concentrations, adhesion molecule expression, leukocyte adhesion, and intestinal tissue edema. Results: In endotoxemic animals with epidural saline, LPS significantly increased the interleukin-1 beta plasma concentration (48%), the expression of endothelial adhesion molecules E-selectin (34%) and ICAM-1 (42%), and the number of adherent leukocytes (40%) with an increase in intestinal myeloperoxidase activity (26%) and tissue edema (75%) when compared to healthy controls. In endotoxemic animals with epidural infusion of lidocaine the values were similar to those in control animals, while epinephrine plasma concentration was 32% lower compared to endotoxemic animals with epidural saline. Conclusions: Thoracic epidural anesthesia attenuated the endotoxin-induced increase of IL-1 beta concentration, adhesion molecule expression and leukocyte-adhesion with subsequent endothelial injury. A potential mechanism is the reduction in the plasma concentration of epinephrine.show moreshow less

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Metadaten
Author: Fabian Enigk, Antje Wagner, Rudi Samapati, Heike Rittner, Alexander Brack, Shaaban A. Mousa, Michael Schäfer, Helmut Habazettl, Jörn Schäper
URN:urn:nbn:de:bvb:20-opus-116787
Document Type:Journal article
Faculties:Medizinische Fakultät / Klinik und Poliklinik für Anästhesiologie (ab 2004)
Language:English
Parent Title (English):BMC Anesthesiology
Year of Completion:2014
Volume:14
Issue:23
Source:BMC Anesthesiology 2014 14:23. doi:10.1186/1471-2253-14-23
DOI:https://doi.org/10.1186/1471-2253-14-23
Pubmed Id:http://www.ncbi.nlm.nih.gov/pubmed?term=24708631
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Tag:adhesion molecules; cell-adhesion; cytokines; endothelial injury; endotoxemia; epidural anesthesia; induced impairment; inflammatory response; intestinal microvascular perfusion; lidocaine; lung injury; myeloperoxidase; neutrophil; reperfusion injury; sepsis
Release Date:2015/08/06
Licence (German):License LogoCC BY: Creative-Commons-Lizenz: Namensnennung