Thoracic epidural anaesthesia reduces insulin resistance and inflammatory response in experimental acute pancreatitis
Aims: The activity of the sympathetic nervous system (SNS) is crucial at an early stage in the development of an inflammatory reaction. A study of metabolic events globally and locally in the early phase of acute pancreatitis (AP), implying hampered SNS activity, is lacking. We hypothesized that tho...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Upsala Medical Society
2018-10-01
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| Series: | Upsala Journal of Medical Sciences |
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| Online Access: | http://dx.doi.org/10.1080/03009734.2018.1539054 |
| _version_ | 1797705687061495808 |
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| author | Ola Winsö Josef Kral Wanzhong Wang Ivana Kralova Pernilla Abrahamsson Göran Johansson Per-Jonas Blind |
| author_facet | Ola Winsö Josef Kral Wanzhong Wang Ivana Kralova Pernilla Abrahamsson Göran Johansson Per-Jonas Blind |
| author_sort | Ola Winsö |
| collection | DOAJ |
| description | Aims: The activity of the sympathetic nervous system (SNS) is crucial at an early stage in the development of an inflammatory reaction. A study of metabolic events globally and locally in the early phase of acute pancreatitis (AP), implying hampered SNS activity, is lacking. We hypothesized that thoracic epidural anaesthesia (TEA) modulates the inflammatory response and alleviates the severity of AP in pigs. Material and methods: The taurocholate (TC) group (n = 8) had only TC AP. The TC + TEA group (n = 8) had AP and TEA. A control group (n = 8) underwent all the preparations, without having AP or TEA. Metabolic changes in the pancreas were evaluated by microdialysis and by histopathological examination. Results: The relative increase in serum lipase concentrations was more pronounced in the TC group than in TC + TEA and control groups. A decrease in relative tissue oxygen tension (PtiO2) levels occurred one hour later in the TC + TEA group than in the TC group. The maintenance of normoglycaemia in the TC group required a higher glucose infusion rate than in the TC + TEA group. The relative decrease in serum insulin concentrations was most pronounced in the TC + TEA group. Conclusion: TEA attenuates the development of AP, as indicated by changes observed in haemodynamic parameters and by the easier maintenance of glucose homeostasis. Further, TEA was associated with attenuated insulin resistance and fewer local pathophysiological events. |
| first_indexed | 2024-03-12T05:41:01Z |
| format | Article |
| id | doaj.art-ee683639e1d84fd59a66414b9f96071d |
| institution | Directory Open Access Journal |
| issn | 0300-9734 2000-1967 |
| language | English |
| last_indexed | 2024-03-12T05:41:01Z |
| publishDate | 2018-10-01 |
| publisher | Upsala Medical Society |
| record_format | Article |
| series | Upsala Journal of Medical Sciences |
| spelling | doaj.art-ee683639e1d84fd59a66414b9f96071d2023-09-03T06:08:01ZengUpsala Medical SocietyUpsala Journal of Medical Sciences0300-97342000-19672018-10-01123420721510.1080/03009734.2018.15390541539054Thoracic epidural anaesthesia reduces insulin resistance and inflammatory response in experimental acute pancreatitisOla Winsö0Josef Kral1Wanzhong Wang2Ivana Kralova3Pernilla Abrahamsson4Göran Johansson5Per-Jonas Blind6Umeå UniversityUmeå UniversityUmeå UniversityUmeå UniversityUmeå UniversityUmeå UniversityUmeå UniversityAims: The activity of the sympathetic nervous system (SNS) is crucial at an early stage in the development of an inflammatory reaction. A study of metabolic events globally and locally in the early phase of acute pancreatitis (AP), implying hampered SNS activity, is lacking. We hypothesized that thoracic epidural anaesthesia (TEA) modulates the inflammatory response and alleviates the severity of AP in pigs. Material and methods: The taurocholate (TC) group (n = 8) had only TC AP. The TC + TEA group (n = 8) had AP and TEA. A control group (n = 8) underwent all the preparations, without having AP or TEA. Metabolic changes in the pancreas were evaluated by microdialysis and by histopathological examination. Results: The relative increase in serum lipase concentrations was more pronounced in the TC group than in TC + TEA and control groups. A decrease in relative tissue oxygen tension (PtiO2) levels occurred one hour later in the TC + TEA group than in the TC group. The maintenance of normoglycaemia in the TC group required a higher glucose infusion rate than in the TC + TEA group. The relative decrease in serum insulin concentrations was most pronounced in the TC + TEA group. Conclusion: TEA attenuates the development of AP, as indicated by changes observed in haemodynamic parameters and by the easier maintenance of glucose homeostasis. Further, TEA was associated with attenuated insulin resistance and fewer local pathophysiological events.http://dx.doi.org/10.1080/03009734.2018.1539054Acute pancreatitisepidural anaesthesiainsulinmicrodialysissodium-taurocholic acidsympathetic nervous system |
| spellingShingle | Ola Winsö Josef Kral Wanzhong Wang Ivana Kralova Pernilla Abrahamsson Göran Johansson Per-Jonas Blind Thoracic epidural anaesthesia reduces insulin resistance and inflammatory response in experimental acute pancreatitis Upsala Journal of Medical Sciences Acute pancreatitis epidural anaesthesia insulin microdialysis sodium-taurocholic acid sympathetic nervous system |
| title | Thoracic epidural anaesthesia reduces insulin resistance and inflammatory response in experimental acute pancreatitis |
| title_full | Thoracic epidural anaesthesia reduces insulin resistance and inflammatory response in experimental acute pancreatitis |
| title_fullStr | Thoracic epidural anaesthesia reduces insulin resistance and inflammatory response in experimental acute pancreatitis |
| title_full_unstemmed | Thoracic epidural anaesthesia reduces insulin resistance and inflammatory response in experimental acute pancreatitis |
| title_short | Thoracic epidural anaesthesia reduces insulin resistance and inflammatory response in experimental acute pancreatitis |
| title_sort | thoracic epidural anaesthesia reduces insulin resistance and inflammatory response in experimental acute pancreatitis |
| topic | Acute pancreatitis epidural anaesthesia insulin microdialysis sodium-taurocholic acid sympathetic nervous system |
| url | http://dx.doi.org/10.1080/03009734.2018.1539054 |
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