The effects of epidural and general anesthesia on tissue oxygenation.

Anesthesia and Analgesia
Tanja TreschanAndrea Kurz

Abstract

The risk of wound infections is inversely related to subcutaneous tissue oxygen tension. General anesthesia increases local blood flow by direct vasodilation and central inhibition of thermoregulatory vasoconstriction. Epidural anesthesia can increase perfusion in blocked regions by decreasing sympathetic tone. We therefore tested the hypothesis that epidural anesthesia increases tissue oxygen tension in awake and anesthetized subjects. Fifteen healthy volunteers underwent epidural, general, and combined epidural and general anesthesia. Subcutaneous tissue oxygen tension was measured using tonometers in the lateral upper arm and the lateral thigh. Epidural anesthesia to a T10 level was maintained with 0.75% mepivacaine. General anesthesia was maintained with 1.5% sevoflurane in 30% oxygen; 30% inspired oxygen was given via a sealed facemask during baseline and epidural anesthesia. Baseline subcutaneous tissue oxygen tensions for arm and thigh were 57 +/- 11 and 54 +/- 8 mm Hg, respectively. Epidural anesthesia significantly increased tissue oxygenation in the thigh by 9 mm Hg, to 63 +/- 7 mm Hg, without increasing arm oxygenation. Tissue oxygenation in the arm and thigh were similar during general anesthesia alone, 58 +/- 11 an...Continue Reading

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Citations

Mar 8, 2014·World Journal of Gastroenterology : WJG·Lesley De PietriBruno Begliomini
Jul 24, 2007·The Journal of Surgical Research·Serdar TopalogluSuleyman Hengirmen
Aug 14, 2012·Paediatric Anaesthesia·Jacob BettesworthJoseph D Tobias
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Jul 1, 2015·Surgical Infections·JoAnne D WhitneyMargot Perrin
Apr 23, 2015·British Journal of Anaesthesia·A KurzUNKNOWN Factorial Trial Investigators
May 24, 2008·Anesthesia and Analgesia·Mohamed H BakriSteven R Insler
Sep 25, 2008·Anesthesiology·Daniel ChappellMarkus Rehm
Jul 27, 2010·Anesthesiology·Daniel I Sessler
Sep 27, 2014·Journal of Autism and Developmental Disorders·Li-Nien ChienHung-Yi Chiou
Feb 22, 2014·Journal of Clinical Monitoring and Computing·Yinan YuJijian Zheng
Nov 8, 2013·Anesthesiology·Itay Bentov, May J Reed
Aug 8, 2019·Clinical Orthopaedics and Related Research·Jacob M WilsonGeorge N Guild
Mar 15, 2006·Current Opinion in Anaesthesiology·Alf KozianThomas Hachenberg
Oct 31, 2019·Orthopaedic Surgery·Jing-Wen LiLiang-Kun Xiao

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