Abstract
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.
MeSH terms
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Aged
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Analgesia, Epidural / methods*
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Anastomosis, Surgical / adverse effects
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Anesthetics, Local / administration & dosage*
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Blood Flow Velocity / drug effects
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Blood Pressure / drug effects
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Bupivacaine / administration & dosage*
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Cardiac Output / drug effects
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Epinephrine / administration & dosage*
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Esophagectomy / adverse effects*
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Female
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Humans
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Infusions, Intravenous
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Injections, Epidural
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Intraoperative Care
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Ischemia / etiology
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Ischemia / physiopathology
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Ischemia / prevention & control
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Laser-Doppler Flowmetry
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Male
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Prospective Studies
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Regional Blood Flow / drug effects
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Stomach / blood supply*
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Stomach / surgery
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Surgically-Created Structures / blood supply*
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Thoracic Vertebrae
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Vasoconstrictor Agents / administration & dosage*
Substances
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Anesthetics, Local
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Vasoconstrictor Agents
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Bupivacaine
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Epinephrine