Epidural Anesthesia in Acute Pancreatitis

Hospital General Naval de Alta Especialidad - Escuela Medico Naval60 enrolled

Overview

Acute pancreatitis is a common urgency with a mortality rate of up to 30% , decreased blood flow in the pancreatic microcirculation. It seems to be the main cause of the pathophysiology of acute pancreatitis. Today, there have been many attempts in the management of pancreatitis but no established management seems to be ideal. The epidural block is an anesthetic technique used to provide highly peri and post-operative analgesia, also plays an important role in improving the gastrointestinal vascular perfusion (due to sympathetic blockade that this technique produces) so this anesthetic technique is proposed as an alternative to both clinical treatment as an analgesic for acute pancreatitis.

The main objective of the study is to evaluate the therapeutic effects of epidural block in patients with acute pancreatitis, comparing day hospital stay among patients receiving intravenous analgesic treatment and patients who are undergoing epidural block. It is a (prospective, comparative, longitudinal, experimental, randomized) controlled clinical trial. They include patients who are diagnosed with acute pancreatitis at the Naval General Hospital of High Specialty. Two groups were taken by random assignment.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Acute Pancreatitis

Epidural anesthesiaDRUG

Epidural anesthesia placed at L1-L2 Epidural infusion of ropivacaine 0.2% + 3-4 mcg/ml fentanyl + saline 0.9% (100 ML) 3-5ml/ hr during 120 hours

intravenous analgesiaDRUG

ketorolac 1mg/kg every 8 hours or metamizol 15 mg/kg every 8 hrs and intravenous opioids (buprenorphine 3 mcg / kg or tramadol 1mg/ kg in continuos infusion

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Patients with acute pancreatitis 2. Patients who agree to participate in the study Exclusion Criteria: 1. Patients who do not agree to participate in the study 2. Patients who experience any absolute contraindication to epidural block 3. Patients with platelet counts below 80,000 mcl 4. Patients with data gastrointestinal or urinary bleeding

Outcomes

Primary Outcomes

Hospital days stay between two groups

Day hospital stay were compared between the analgesic management with epidural and intravenous analgesic management

Time frame: 10-15 days

Secondary Outcomes

Efficacy of Epidural pain control

Measured by pain scales the effectiveness of epidural use as an analgesic in acute pancreatitis

Time frame: 24, 48, 72, 96,120 hours

Decreased pancreatic enzymes

Recording every 24 hours of laboratory values, these values decreased observing and evaluating the clinical status of the patient

Time frame: 24,48,72,96,120 hours post dose