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Anesth Analg 2008; 106:884-887
© 2008 International Anesthesia Research Society
doi: 10.1213/ane.0b013e318164f153
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CRITICAL CARE AND TRAUMA

The Effect of Thoracic Epidural Bupivacaine and an Intravenous Adrenaline Infusion on Gastric Tube Blood Flow During Esophagectomy

Omar Y. Al-Rawi, FRCA*, Stephen H. Pennefather, MRCP, FRCA*, Richard D. Page, FRCS{dagger}, Ishani Dave, FRCA*, and Glen N. Russell, FRCA*

From the Departments of *Anaesthesia and {dagger}Thoracic Surgery, Cardiothoracic Centre, Liverpool, United Kingdom.

Address correspondence to Stephen H. Pennefather, MRCP, FRCA, Department of Anaesthesia, Cardiothoracic Centre, Thomas Drive, Liverpool L14 3PE, UK. Address e-mail to stephen.pennefather{at}ctc.nhs.uk.

BACKGROUND: Gastric tube necrosis is a major cause of anastomotic leak after esophagectomy. A correlation has been shown between reduced flux at the anastomotic end of the gastric tube and anastomotic leaks.

METHODS: We prospectively studied the effect of intraoperative thoracic epidural bupivacaine and subsequent adrenaline infusion on hemodynamics and flux in the gastric tube.

RESULTS: Administering the epidural bolus significantly decreased flux at the anastomotic end of the gastric tube (P < 0.01). Gastric flux was returned to baseline by an adrenaline infusion.

CONCLUSIONS: The administration of a thoracic epidural bolus may decrease flux at the anastomotic end of the gastric tube.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2008 by the International Anesthesia Research Society.