Epidural anesthesia improves pancreatic perfusion and decreases the severity of acute pancreatitis

Table 1 Clinical characteristics of patients with severe acute pancreatitis

Factor	Epidural anesthesia(n = 13)	Control group(n = 22)	P value1
Demographics
Age (yr)	66.08 (11.67)	57.36 (17.97)	0.092
Male sex, n (%)	7 (55.8)	12 (54.5)	0.968
BMI (kg/m2)	27.82 (6.13)	29.15 (7.08)	0.623
Pain duration prior hospitalization (h)	87.46 (198.85)	90.86 (208.36)	0.962
Comorbid conditions, n (%)			0.561
Diabetes	3 (23.1)	3 (13.6)
Hypertension	2 (15.4)	7 (31.8)
High cholesterol	2 (15.4)	3 (13.6)
Obesity	1 (7.7)	5 (22.7)
Chronic alcoholism	3 (23.1)	3 (13.6)
Cardiovascular condition	2 (15.4)	1 (4.5)
Aetiology of pancreatitis, n (%)			0.901
Alcoholic	3 (23.1)	6 (27.27)
Biliary	7 (53.8)	13 (59.1)
Hyperlipidaemia	1 (7.7)	1 (4.5)
Medication	0	0
Unknown	2 (15.4)	2 (9.1)
Ranson score at admission	3.38 (1.12)	2.68 (0.945)	0.056

¹Groups were compared with a t-test for continuous variables (or Wilcoxon Mann-Whitney test) and a Pearson χ² test (or Fisher exact test) for categorical variables. Values are mean (standard deviation) for continuous variables and n (%) for categorical variables.

Table 2 Clinical outcome of patients with severe acute pancreatitis

Factor	Epidural anesthesia(n = 13)	Control group(n = 22)	P value1
Biochemical data
Blood pH at admission	7.4 (0.05)	7.38 (0.07)	0.270
Blood pH day 2	7.43 (0.04)	7.4 (0.04)	0.180
CRP at admission (mg/L)	58 (102)	87 (118)	0.470
CRP day 2	274 (108)	245 (145)	0.550
Glucose at admission (mmol/L)	10.66 (4.29)	9.5 (4.76)	0.480
Glucose day 2	8.36 (2.1)	7.9 (3.07)	0.630
Amylase at admission (U/L)	1479 (1183)	1700 (1374)	0.640
Amylase day 2	239 (188)	306 (262)	0.440
Lipase at admission (U/L)	1844 (1568)	1804 (1675)	0.940
Lipase day 2	108 (68)	211 (261)	0.190
CT at admission Balthazar score	4.15 (2.54)	3.38 (1.75)	0.347
CT day 2 Balthazar score	4.69 (2.59)	4.17 (2.01)	0.548
CT guided puncture	5 (38.5%)	10 (45.5%)	0.686
Infected	1 (20%)	6 (54.5%)	0.308
Surgical treatments
Cholecystectomy	5 (38.5%)	13 (59.1%)	0.240
Necrosectomy	1 (7.7%)	4 (18.2%)	0.630
Caudal pancreatectomy		1
Clinical severity
ICU	4 (33.3%)	10 (45.5%)	0.493
Sepsis	0 (0%)	2 (10%)	0.508
Intubation	1 (7.7%)	6 (27.3%)	0.220
Medical treatments
Antibiotics	8 (61.5%)	15 (68.2%)	0.689
Nb of days	19.7 (13.2)	16.3 (12.75)	0.580
Systemic complications	10 (76.9%)	13 (59.1%)	0.283
Grading 1-4	1.77 (1.64)	1.73 (1.75)	0.945
Loco regional complications	9 (69.2%)	12 (54.5%)	0.392
Grading 1-4	1.54 (1.45)	1.55 (1.65)	0.990
Length of stay (d)	26.15 (21.94)	30.05 (25.06)	0.646
Death	0	0	1
Pain score VAS
Before randomization	6.55 (3.39)	7.31 (3.44)	0.572
VAS day0, EA implementation	1.6 (1.838)	3.5 (2.2)	0.020
VAS day 1	0.57 (1.51)	2.0 (2.89)	0.066
VAS day 2	1.63 (3.46)	1.67 (2.693)	0.637
VAS day 5	1.86 (3.485)	1.38 (1.768)	0.694
VAS day 7	3 (2.38)	2 (2.39)	0.346
VAS day 10	0.2 (0.447)	2.33 (2.309)	0.034
VAS day 12	2.8 (2.28)	0 (0)	0.071

¹Groups were compared with a t-test for continuous variables (or Wilcoxon Mann-Whitney test) and a Pearson χ² test (or Fisher exact test) for categorical variables. Values are mean +/- SD for continuous variables and n (%) for categorical variables.