Thoracic epidural anesthesia with bupivacaine attenuates systemic inflammatory response and lung impairment associated with cerulein-induced pancreatitis in rats

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To evaluate the effects of thoracic epidural anesthesia (TEA) on acute pancreatitis (AP)-induced lung injury in a rat model. Materials and methods: A total of 24 rats were divided into 3 groups: the control group (n = 8; pancreatitis), the bupivacaine group (n = 8; pancreatitis + 20 µL/h 0.5% bupivacaine), and the saline group (n = 8, pancreatitis + 20 µL/h saline). Pancreatitis was induced by 4 intraperitoneal injections of 50 µg/kg cerulein. At 24 h, blood was collected for determination of amylase, blood gas, tumor necrosis factor-\alpha (TNF-\alpha), interleukin (IL)-6, and IL-1\beta; lung samples were collected for the measurement of glutathione peroxidase (GPx), superoxide dismutase (SOD), catalase (CAT), and myeloperoxidase (MPO) concentrations and for immunohistochemical examinations, apoptosis determination, and wet/dry ratio determinations. Pancreas samples were collected for the histological investigation to confirm AP. Results: Serum amylase decreased significantly in the bupivacaine group when compared to the control and saline groups. Bupivacaine showed a significant decrease in the TNF-\alpha and IL-1\beta concentrations and an increase in the GPx and SOD concentrations compared to both the saline and control groups. The wet/dry ratio showed a significant difference between the control and bupivacaine groups. Bupivacaine significantly decreased the injury score, apoptosis, and ICAM-1 secretion in the lung tissue. Conclusion: The present study demonstrated that TEA with bupivacaine decreased the systemic inflammation and lung injury due to AP.