• Anesthesia and analgesia · Mar 2008

    Clinical Trial

    The effect of thoracic epidural bupivacaine and an intravenous adrenaline infusion on gastric tube blood flow during esophagectomy.

    • Omar Y Al-Rawi, Stephen H Pennefather, Richard D Page, Ishani Dave, and Glen N Russell.
    • Department of Anaesthesia, Cardiothoracic Centre, Thomas Drive, Liverpool L14 3PE, UK.
    • Anesth. Analg. 2008 Mar 1; 106 (3): 884-7, table of contents.

    BackgroundGastric 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.MethodsWe prospectively studied the effect of intraoperative thoracic epidural bupivacaine and subsequent adrenaline infusion on hemodynamics and flux in the gastric tube.ResultsAdministering 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.ConclusionsThe administration of a thoracic epidural bolus may decrease flux at the anastomotic end of the gastric tube.

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