Authors: Al-Rawi, Omar Y. FRCA *; Pennefather, Stephen H. MRCP, FRCA *; Page, Richard D. FRCS +; Dave, Ishani FRCA *; Russell, Glen N. FRCA *

Institution From the Departments of *Anaesthesia and +Thoracic Surgery, Cardiothoracic Centre, Liverpool, United Kingdom.

Title The Effect of Thoracic Epidural Bupivacaine and an Intravenous Adrenaline Infusion on Gastric Tube Blood Flow During Esophagectomy.[Report]

Source Anesthesia & Analgesia. 106(3):884-887, March 2008.

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.