The Effect Of Thoracic Epidural Anesthesia On The Interstitial Cells Of Cajal After Intestinal Ischemic And Reperfusion Injury

Objectives:1. To investigate the feasibility and effect of rat epidural anesthesia models by modifyingfixation of the epidural catheter.2. To research the role and mechanism of the thoracic epidural anesthesia on interstitialcells of Cajal after intestinal I/R injury.Methods:1.24male Wistar rats, used to build epidural anesthesia models, were randomly dividedinto experimental group (n=12) and control group (n=12). After inserted thecatheter, the catheter were fixed by some blocks designed with sterile adhesive tapeand the catheter connector were replaced by sterile medical tape in the experimentalgroup, while catheter was fixed with wire wound and catheter connector was suturedon the back of the neck in the control group.0.1%ropivacaine30ul was injected intoepidural space once a day and continued28days. Then incidence of postoperativeinfection, the time to failure of the epidural anesthesia models was recorded and theepidural catheter depth measured on the28th day.2.32Wistar rats were randomly divided into four groups (n=8): group S (sham group),group I/R (intestinal ischemia and reperfusion), group NS (mesentericischemia/reperfusion and thoracic epidural normal saline), and group TEA(mesenteric ischemia/reperfusion and thoracic epidural anesthesia). Rats in groupTEA and group NS received thoracic epidural0.075%ropivacaine and0.9%normalsaline100ul/kg respectively, starting5min before reperfusion and once every3hoursfor a total of4times. Small intestine specimens were used for HE staining to confirmischemia-reperfusion injury, for immunohistochemistry and qRT-PCR to measure theexpression of c-Kit,12h after reperfusion. Results:1. No significant difference was noted in the incidence of postoperative infectionbetween two groups (P>0.05). The effective duration of models in the experimentalgroup is significantly longer than that in the control group (P<0.05). The epiduralcatheter depth were1.81±0.07cm in the experimental group, respectively, whereasin the control group,1.44±0.55cm of the depth were detected, the degree ofdispersion is lower than that in the control group (P<0.05).2. Chiu’s score was increased(P<0.05), c-Kit protein and mRNA expression wasdecreased(P<0.05)12h after reperfusion in group I/R, group NS, group TEA.Compared with the group I/R, Chiu’s score was decreased(P<0.05), c-Kit protein andmRNA expression(P<0.05) was increased in group TEA, and no significant differentin group NS.Conclusion:1. Modified catheter fixation can significantly improve the stability and success rate ofepidural anesthesia animal models.2. Intestinal I/R injury induced small intestinal injury, ICC structural and functionalchanges.3. Thoracic epidural anesthesia reduced the damage of the ICC after ischemia andreperfusion, thus contributing to the recovery of gastrointestinal motility.