30. Continuous ropivacaine infusion via epidural catheter improving gastrointestinal dysfuncion in acute pancreatitis: A preliminary study
Main Article Content
Abstract
This preliminary study aimed to evaluate the effectiveness of continuous infusion of ropivacaine via an epidural catheter in improving gastrointestinal dysfunction in patients with severe or predicted severe pancreatitis. Of 27 patients, 21(77.8%) were male, and the mean age was 49 ± 10.9 years. Fourteen patients were in the epidural analgesia (EA) group and thirteen patients were in the non-epidural analgesia (NEA) group. There was a trend of improvement of GIF score in the EA group. The mean of GIF score day 1, day 2 and day 3 in the epidural group was significantly less than NEA group (2.19 ± 0.65 vs 2.77 ± 0.76, p-value = 0.043). In a population of critical care unit adults with severe acute pancreatitis or predicted severe acute pancreatitis, this preliminary study showed that continuous infusion of ropivacaine via an epidural catheter may have some benefits in gastrointestinal function. Further comparative investigations with large study populations and multicenter data are necessary.
Article Details
Keywords
Acute pancreatitis, pain control, organ failure, gastrointestinal failure, epidural anesthesia
References
2. Forsmark CE, Vege SS, Wilcox CM. Acute Pancreatitis. N Engl J Med. 2016; 375(20): 1972-1981. doi:10.1056/NEJMra1505202.
3. Agarwala R, Rana SS, Sharma R, et al. Gastrointestinal Failure Is a Predictor of Poor Outcome in Patients with Acute Pancreatitis. Dig Dis Sci. 2020; 65(8): 2419-2426. doi:10.1007/s10620-019-05952-5.
4. Jabaudon M, Genevrier A, Jaber S, et al. Thoracic epidural analgesia in intensive care unit patients with acute pancreatitis: the EPIPAN multicenter randomized controlled trial. Crit Care Lond Engl. 2023; 27(1): 213. doi:10.1186/s13054-023-04502-w.
5. Hui RWH, Leung CM. Thoracic Epidural Analgesia in Acute Pancreatitis: A Systematic Review. Pancreas. 2022; 51(7): e95-e97. doi:10.1097/MPA.0000000000002111
6. Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013; 62(1): 102-111. doi:10.1136/gutjnl-2012-302779.
7. Reintam A, Parm P, Kitus R, et al. Gastrointestinal Failure score in critically ill patients: a prospective observational study. Crit Care. 2008; 12(4): R90. doi:10.1186/cc6958.
8. Tyagi A, Gupta YR, Das S, et al. Effect of Segmental Thoracic Epidural Block on Pancreatitisinduced Organ Dysfunction: A Preliminary Study. Indian J Crit Care Med Peer-Rev Off Publ Indian Soc Crit Care Med. 2019; 23(2): 89-94. doi:10.5005/jp-journals-10071-23123.