Effect of Acute Sympathectomy by Epidural Anesthesia on the Canine Coronary Circulation

Klassen, Gerald A.; Bramwell, R.; Bromage, Philip R.; Zborowska-Sluis, Danuta

doi:10.1097/00000542-198001000-00003

Cited by 129 publications

(17 citation statements)

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“…[66][67][68] TEA has been shown in canine models to improve cardiac regional blood flow so as to favor the endocardium. 69,70 One important question currently being addressed in both experimental and clinical studies is the complex effects of epidural anesthesia on gastrointestinal perfusion. Interruption of sympathetic activity and mesenteric venodilatation by TEA are dose dependent and related to the extent of the block.…”

Section: Microcirculatory Effects Of Epidural Anesthesiamentioning

confidence: 99%

Anesthesia and the Microcirculation

Turek

Sýkora

Matějovič

et al. 2009

Semin Cardiothorac Vasc Anesth

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There is increasing evidence that the microcirculation and its regulation are severely compromised during many pathological conditions, such as hemorrhage, sepsis, or trauma. The effects of anesthetic agents on macrohemodynamics were investigated intensively in the last several decades. Research regarding modern anesthetics and anesthesia techniques has increased knowledge regarding the nonanesthetic effects of anesthetic agents, including those on organ perfusion and the microcirculation. Alterations in microvascular reactivity, nitric oxide pathways, and cytokine release are presumably the main mechanisms of anesthetic-induced tissue perfusion changes. This review summarizes current methods of microcirculatory status assessment and current knowledge regarding the microcirculatory effects of intravenous and potent volatile anesthetics and anesthesia-related techniques under both normal and pathophysiological conditions.

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Section: Microcirculatory Effects Of Epidural Anesthesiamentioning

confidence: 99%

Anesthesia and the Microcirculation

Turek

Sýkora

Matějovič

et al. 2009

Semin Cardiothorac Vasc Anesth

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“…TEB may act by decreasing the determinants of myocardial oxygen demand. It has been demonstrated that TEB decreases blood pressure by 13%, heart rate by 7%, and pulmonary capillary wedge pressure by 42% without significant changes in coronary perfusion pressure or cardiac output [10]. Additionally, the beneficial effects of TEB can be attributed to the reduction in peripheral vascular resistance secondary to diminished sympathetic tone and a decrease in venous return to the heart.…”

mentioning

confidence: 99%

Effects of thoracic epidural blockade on mortality of patients with idiopathic dilated cardiomyopathy and heart failure

Chi

Rong

Lei

et al. 2011

International Journal of Cardiology

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“…Either anesthesia or analgesia can independently reduce positive feedback and surgical stress to the point that most patients survive surgery, [491-493, 609, 610] but outcome is further enhanced if synergistic combinations of anesthesia and analgesia are maintained continuously throughout surgery. [16,235,236,325,461,462,470,491,492,496,513,514,526,541,[611][612][613][614][615][616][617][618][619][620][621][622][623][624][625][626][627][628][629][630]. Such combinations beneficially prevent thrombin acceleration, inhibit thrombin-induced immune activity and inflammatory effects, [631] reduce blood viscosity and coagulability, improve tissue perfusion and oxygenation, protect organ function, maintain cardiac output, reduce blood pressure, increase ejection fraction, slow heart rate via the Starling Mechanism and reduce the risk of malignancy and heart disease in the distant aftermath of surgery [216,230,235,240,325,514,…”

Section: Surgical Stress Syndromementioning

confidence: 99%

A Stress Repair Mechanism That Maintains Vertebrate Structure During Stress

Coleman

2010

CHDDT

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Based on Capillary Gate Theory and Tissue Repair Theory, this paper describes the "Stress Repair Mechanism" (SRM) that maintains and repairs vertebrate tissues. It accounts for most of the mysterious manifestations of allostasis that remain unexplained by Hypothalamic-Pituitary-Axis (HPA) hormones and thereby enables the Universal Theory of Medicine predicted by Hans Selye. SRM activity explains hemodynamic physiology, capillary hemostasis, infarction, Korotkoff sounds, blood pressure, hypertension, diabetes, allostasis, allostatic load, anesthesia, analgesia, atherosclerosis, apoptosis, malignancy, eclampsia, sepsis, Multi-System Organ Failure (MSOF), the surgical stress syndrome, the fight or flight response, and numerous other manifestations of physiology and pathology. SRM function comprises the autonomic nervous system, the vascular endothelium, and the dynamic enzymatic interaction of blood-borne hepatic Factors VII, VIIIC, IX and X that produces thrombin, soluble fibrin and insoluble fibrin, whose combined effects account for all SRM manifestations. The vascular endothelium is a diaphanous neuroendocrine organ that lines all blood vessels and is the sole constituent of capillary walls. It secretes tissue factor into extravascular tissues, and insulates those tissues from the hepatic enzymes, so that tissue disruption exposes tissue factor to the enzymatic interaction and activates tissue repair. The vascular endothelium also releases nitric oxide and von Willebrand Factor into blood in accord with autonomic balance to regulate the enzymatic interaction to govern tissue perfusion and organ function. Therefore, continuously fluctuating combinations of nervous stimuli that affect autonomic balance and forces that disrupt tissues determine SRM activity.

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Effect of Acute Sympathectomy by Epidural Anesthesia on the Canine Coronary Circulation

Cited by 129 publications

References 0 publications

Anesthesia and the Microcirculation

Anesthesia and the Microcirculation

Effects of thoracic epidural blockade on mortality of patients with idiopathic dilated cardiomyopathy and heart failure

A Stress Repair Mechanism That Maintains Vertebrate Structure During Stress

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