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| 1 | Epidural anesthesia improves pancreatic perfusion and decreases the severity of acute pancreatitis显示文摘AIM: To study the safety of epidural anesthesia(EA),its effect on pancreatic perfusion and the outcome of patients with acute pancreatitis(AP).METHODS: From 2005 to August 2010,patients with predicted severe AP [Ranson score ≥ 2,C-reactive protein > 100 or necrosis on computed tomography(CT)] were prospectively randomized to either a group receiving EA or a control group treated by patientcontrolled intravenous analgesia. Pain management was evaluated in the two groups every eight hours using the visual analog pain scale(VAS). Parameters for clinical severity such as length of hospital stay,use of antibiotics,admission to the intensive care unit,radiological/clinical complications and the need for surgical necrosectomy including biochemical data were recorded. A CT scan using a perfusion protocol was performed on admission and at 72 h to evaluate pancreatic blood flow. A significant variation in blood flow was defined as a 20% difference in pancreatic perfusion between admission and 72 h and was measured in the head,body and tail of the pancreas.RESULTS: We enrolled 35 patients. Thirteen were randomized to the EA group and 22 to the control group. There were no differences in demographic characteristics between the two groups. The Balthazar radiological severity score on admission was higher in the EA group than in the control group(mean score 4.15 ± 2.54 vs 3.38 ± 1.75,respectively,P = 0.347) and the median Ranson scores were 3.4 and 2.7 respectively(P = NS). The median duration of EA was 5.7 d,and no complications of the epidural procedure were reported. An improvement in perfusion of the pancreas was observed in 13/30(43%) of measurements in the EA group vs 2/27(7%) in the control group(P = 0.0025). Necrosectomy was performed in 1/13 patients in the EA group vs 4/22 patients in the control group(P = 0.63). The VAS improved during the first ten days in the EA group compared to the control group(0.2 vs 2.33,P = 0.034 at 10 d). Length of stay and mortality were not statistically different between the 2 groups(26 d vs 30 d,P = 0.65,and 0% for both respectively).CONCLUSION: Our study demonstrates that EA increases arterial perfusion of the pancreas and improves the clinical outcome of patients with AP. | Samira M Sadowski Axel Andres Philippe Morel Eduardo Schiffer Jean-Louis Frossard Alexandra Platon Pierre-Alexandre Poletti Leo Bühler | 2015 | World Journal of Gastroenterology2015，21，43： | 21 |
| 2 | Lipid peroxidation products and antioxidants in human disease显示文摘 | Romero F J Morell F B Romero M J | 1998 | Environ Health Perspect1998，106，： | 1 |
| 3 | A review of image denoising algorithms with a new one显示文摘 | Buades A Coll B Morel J M | 2005 | Multiscale Modeling and Simulation:A SIAM Interdisciplinary Journal2005，4，2： | 1 |
| 4 | A review of image denoising algorithms, with a new one 显示文摘 | BUADES A COLL B MOREL J M | 2005 | Multiscale Modeling and Simulation2005，4，2： | 1 |
| 5 | A review of image denoising algorithms,with a new one显示文摘 | Buades A Coll B Morel J M | 2005 | Multiscale Model Simul2005，4，2： | 1 |
| 6 | Effect of nitric oxide on iron-mediated oxidative stress in primary rat hepatocyte culture显示文摘 | Sergent O Griffon B Morel I | 1997 | Hepatology1997，26，1： | 1 |
| 7 | A review of image denoising algorithms,with a new one显示文摘 | Buades A Coll B Morel J | 2005 | Multiscale Modeling and Simulation2005，4，2： | 1 |
| 8 | A non-local algorithm for im- age denoising显示文摘 | Buades A Colt B Morel J M | 2005 | IEEE Computer Vision and Pattern Rec- ognition2005，2，： | 1 |
| 9 | Neighborhood Filters and PDE's显示文摘 | Buades A Coll B Morel J M | 2006 | Numerische Mathematik2006，105，1： | 1 |
| 10 | Nonlocal image and movie denoising 显示文摘 | BUADES A COLL B MOREL J M | 2007 | International Journal of Computer Vision2007，76，2： | 1 |
| 11 | Proper Bit and Underreamer Synchroniza-tion Concept Delivered Excellent Performance in GOMDeep Well 显示文摘 | Morel B | 2010 | OTC 210262010，，： | 1 |
| 12 | On image denoising methods显示文摘 | BUADES A COLL B MOREL J M | | 0，，： | 1 |
| 13 | Effect of nitric oxide on iron-mediated oxidative stress in primary rat hepatocyte culture显示文摘 | Sergent O Griffon B Morel I | | 0，，01： | 1 |
| 14 | A review of image de- noising algorithms, with a new one 显示文摘 | Buades A Coil B Morel J M | 2005 | Multiseale Modeling & Simulation2005，4，2： | 1 |
| 15 | SPARTACAS:Automating components reuse and adaptation显示文摘 | Morel B Alexander P | 2004 | IEEE Transactions on Software Engineering2004，30，9： | 1 |
| 16 | On image denoising methods 显示文摘 | BUADES A COLL B MOREL J M | 2005 | SIAM Multiscale Modeling and Simulation2005，4，2： | 1 |
| 17 | On Image Denoising Method显示文摘 | Baudes A Coll B Morel J M | 2005 | SIAM Multiscale Modeling and Simulation2005，4，2： | 1 |
| 18 | Fertile hypomorphic Argonaute (agol)mutants impaired on post transcriptional gene silencing and virus resistans显示文摘 | Morel J B Godon C Mourrain P | 2002 | Plant Cell2002，14，3： | 1 |
| 19 | A review of image de-noising algorithms, with a new one 显示文摘 | BUADES A COLL B MOREL J M | 2005 | Multi-scale Modeling and Simulation2005，4，： | 1 |
| 20 | Neighborhood filters and PDE′s显示文摘 | BUADES A COLL B MOREL J M | | 0，，10： | 1 |
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