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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...

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Autores principales: Winsö, Ola, Kral, Josef, Wang, Wanzhong, Kralova, Ivana, Abrahamsson, Pernilla, Johansson, Göran, Blind, Per-Jonas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6327622/
https://www.ncbi.nlm.nih.gov/pubmed/30468105
http://dx.doi.org/10.1080/03009734.2018.1539054
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author Winsö, Ola
Kral, Josef
Wang, Wanzhong
Kralova, Ivana
Abrahamsson, Pernilla
Johansson, Göran
Blind, Per-Jonas
author_facet Winsö, Ola
Kral, Josef
Wang, Wanzhong
Kralova, Ivana
Abrahamsson, Pernilla
Johansson, Göran
Blind, Per-Jonas
author_sort Winsö, Ola
collection PubMed
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 (PtiO(2)) 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.
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spelling pubmed-63276222019-01-22 Thoracic epidural anaesthesia reduces insulin resistance and inflammatory response in experimental acute pancreatitis Winsö, Ola Kral, Josef Wang, Wanzhong Kralova, Ivana Abrahamsson, Pernilla Johansson, Göran Blind, Per-Jonas Ups J Med Sci Article 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 (PtiO(2)) 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. Taylor & Francis 2018-12 2018-11-23 /pmc/articles/PMC6327622/ /pubmed/30468105 http://dx.doi.org/10.1080/03009734.2018.1539054 Text en © 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Article
Winsö, Ola
Kral, Josef
Wang, Wanzhong
Kralova, Ivana
Abrahamsson, Pernilla
Johansson, Göran
Blind, Per-Jonas
Thoracic epidural anaesthesia reduces insulin resistance and inflammatory response in experimental acute pancreatitis
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 Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6327622/
https://www.ncbi.nlm.nih.gov/pubmed/30468105
http://dx.doi.org/10.1080/03009734.2018.1539054
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