Thoracic epidural anesthesia decreases endotoxin-induced endothelial injury

BMC Anesthesiology

Research Article

Heike Rittner¹  Alexander Brack¹  Fabian Enigk²  Antje Wagner²  Michael Schäfer³  Shaaban A Mousa³  Jörn Schäper⁴  Rudi Samapati⁵  Helmut Habazettl⁶ 

[1] Department of Anesthesia and Critical Care, Josef-Schneider-Straße 2, 97080, Würzburg, Germany;Department of Anesthesiology and Operative Intensive Care Medicine, Charité–Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany;Department of Anesthesiology and Operative Intensive Care Medicine, Charité–Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany;Department of Anesthesiology, Emergency Medicine and Critical Care Medicine, Universitätsmedizin Göttingen, Robert-Koch-Straße 40, 37099, Göttingen, Germany;Institute of Physiology, Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany;Institute of Physiology, Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany;Department of Anesthesiology and Operative Intensive Care Medicine, Charité–Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany;

关键词: Epidural anesthesia;    Lidocaine;    Endotoxemia;    Endothelial injury;    Cytokines;    Adhesion molecules;    Myeloperoxidase;   

DOI  :  10.1186/1471-2253-14-23

 received in 2013-12-02, accepted in 2014-03-31,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundThe 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.MethodsSprague 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.ResultsIn endotoxemic animals with epidural saline, LPS significantly increased the interleukin-1β 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.ConclusionsThoracic epidural anesthesia attenuated the endotoxin-induced increase of IL-1β concentration, adhesion molecule expression and leukocyte-adhesion with subsequent endothelial injury. A potential mechanism is the reduction in the plasma concentration of epinephrine.

【 授权许可】

Unknown   
© Enigk et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.