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Related Experiment Videos

Continuous epidural blockade arrests the postoperative decrease in muscle protein fractional synthetic rate in

F Carli1, D Halliday

  • 1Department of Anesthesia, McGill University, Royal Victoria Hospital, Montreal, Quebec, Canada. mdfc@musica.mcgill.ca

Anesthesiology
|May 1, 1997
PubMed
Summary

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Epidural anesthesia preserves muscle protein synthesis after surgery by blocking pain signals. This protein-sparing effect helps maintain muscle health during recovery.

Area of Science:

  • Anesthesiology
  • Surgical Recovery
  • Metabolic Research

Background:

  • Epidural anesthesia with local anesthetics is known to reduce postoperative nitrogen loss, suggesting a protein-sparing effect.
  • This effect may stem from reduced protein breakdown or enhanced protein synthesis.
  • While epidural anesthesia's impact on whole-body protein breakdown is understood, its direct effect on muscle protein synthesis requires investigation.

Purpose of the Study:

  • To determine if blocking nociceptive stimuli via epidural anesthesia directly influences muscle protein fractional synthetic rate.
  • To investigate the impact of epidural anesthesia on muscle protein synthesis post-colorectal surgery.

Main Methods:

  • Twelve patients undergoing elective colorectal surgery were randomized into general anesthesia (control) or epidural anesthesia groups.

Related Experiment Videos

  • Muscle protein fractional synthetic rate was measured using a 6-hour infusion of 13C-labeled leucine before and 48 hours after surgery.
  • Epidural anesthesia involved a T3-S5 sensory block with bupivacaine, followed by a continuous epidural bupivacaine infusion (T8-L5) for 48 hours post-surgery.

    • Main Results:

    • Muscle protein synthesis significantly decreased in the control group 48 hours post-operation compared to preoperative levels (P = 0.03).
    • In contrast, the epidural anesthesia group showed a 25% increase in muscle protein synthesis, which was significantly higher than in the control group.
    • While not significantly different from preoperative levels, the increase in the epidural group indicated preservation of muscle protein synthesis.

    Conclusions:

    • Continuous epidural anesthesia initiated before surgery and maintained for 48 hours post-operation significantly mitigates the decline in muscle protein synthesis.
    • Effective blockade of nociceptive stimuli through epidural anesthesia plays a crucial role in preserving tissue protein synthesis following surgical injury.
    • This study highlights the direct benefit of epidural anesthesia in maintaining muscle protein synthesis rates during the early postoperative period.