What question did this study set out to answer?

To evaluate the impact of postoperative thoracic epidural analgesia versus intravenous analgesia on local extracellular glycerol, glucose, and lactate metabolism in subcutaneous adipose tissue.

May 1, 2002Acta Anaesthesiologica ScandinavicaOpen Access

Local metabolic changes in subcutaneous adipose tissue during intravenous and epidural analgesia

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Why the study?

Does thoracic epidural analgesia with bupivacaine/morphine alter extracellular glycerol, glucose, and lactate concentrations in subcutaneous adipose tissue compared to continuous i.v. morphine in patients undergoing major abdominal or thoraco-abdominal surgery?

Population

14 patients who underwent major abdominal or thoraco-abdominal surgery

Comparison

Thoracic epidural analgesia with a… vs Continuous i.v. infusion of morphine

Design

RCT, prospectively randomized

Follow-up

3 days postoperatively

Authors

PEPer EderothSpectrum Health PFPer FlisbergHelsingborgs lasarett UUUrban UngerstedtUniversity College Dublin

Discussion

Member takes

Implication

Thoracic epidural analgesia may regionally modulate postoperative lipolysis; extends sympathetic blockade evidence to adipose tissue metabolism.

Key Points

To evaluate the impact of postoperative thoracic epidural analgesia versus intravenous analgesia on local extracellular glycerol, glucose, and lactate metabolism in subcutaneous adipose tissue.
Fourteen patients undergoing major abdominal or thoraco-abdominal surgery were prospectively randomized to receive either thoracic epidural analgesia (EPI-group, n=6; bupivacaine/morphine infusion) or continuous intravenous morphine infusion (MO-group, n=8) for 3 postoperative days.
Microdialysis catheters measured extracellular concentrations of glycerol, glucose, and lactate in both abdominal and deltoid subcutaneous adipose tissue.
Abdominal subcutaneous adipose tissue glycerol concentrations were equivalent between the epidural and intravenous morphine groups throughout the 3-day postoperative period.
Deltoid subcutaneous glycerol concentrations increased on Day 2 and were significantly higher on Day 3 in the epidural group compared with the intravenous morphine group.
Glucose and lactate concentrations in subcutaneous adipose tissue showed no significant differences between the two analgesia groups across either anatomical site.

Structured PICO

Population

14 patients who underwent major abdominal or thoraco-abdominal surgery

Intervention

Thoracic epidural analgesia with a bupivacaine/morphine infusion

Comparator

Continuous i.v. infusion of morphine

Outcome

Concentration of glycerol, glucose and lactate in the abdominal and deltoid subcutaneous adipose tissuesurrogate

Thoracic epidural analgesia may exert a regional metabolic influence on lipolysis, possibly via the sympathetic nervous system, as evidenced by differential glycerol levels in deltoid versus abdominal subcutaneous adipose tissue.

Cite This Study

Ederoth et al. (2002) studied this question.

synapsesocial.com/papers/6a82ad74342cda0577239aad https://doi.org/10.1034/j.1399-6576.2002.460517.x

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Implication

Thoracic epidural analgesia may regionally modulate postoperative lipolysis; extends sympathetic blockade evidence to adipose tissue metabolism.

Local metabolic changes in subcutaneous adipose tissue during intravenous and epidural analgesia

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Local metabolic changes in subcutaneous adipose tissue during intravenous and epidural analgesia

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

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