Local metabolic changes in subcutaneous adipose tissue during intravenous and epidural analgesia.

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BACKGROUND: This clinical study aimed at investigating the impact of postoperative thoracic epidural analgesia on extracellular glycerol concentration and glucose metabolism in subcutaneous adipose tissue, using the microdialysis technique. The sympathetic nervous activity, which can be attenuated by epidural anesthesia, influences lipolysis and the release of glycerol. METHODS: Fourteen patients who underwent major abdominal or thoraco-abdominal surgery were studied postoperatively over 3 days. For postoperative analgesia the patients were prospectively randomized to receive either thoracic epidural analgesia with a bupivacaine/morphine infusion (EPI-group, n=6) or a continuous i.v. infusion of morphine (MO-group, n=8). The concentration of glycerol, glucose and lactate in the abdominal and deltoid subcutaneous adipose tissue were measured using a microdialysis technique. RESULTS: The abdominal glycerol levels were equal in both groups. In the deltoid region of the EPI-group, glycerol concentrations started to increase on Day 2, and reached significantly higher levels on Day 3 compared with the MO-group. The glucose and lactate levels showed no differences between groups in the two regions. CONCLUSION: The uniform glycerol levels in abdominal subcutaneous adipose tissue in conjunction with the difference in glycerol levels in the deltoid area indicate that the local lipolysis is different in the two study groups. This might be explained by a regional metabolic influence of thoracic epidural analgesia, possibly via the sympathetic nervous system.


  • Per Ederoth
  • Per Flisberg
  • U Ungerstedt
  • C-H Nordström
  • Johan Lundberg
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Anesthesiology and Intensive Care


  • Adipose Tissue : metabolism, Postoperative : drug therapy, Pain, Microdialysis, Male, Intravenous, Injections, Human, Glycerol : metabolism, Glucose : metabolism, Female, Extracellular Space : metabolism, Area Under Curve, Epidural, Analgesia, Adult
Original languageEnglish
Pages (from-to)585-591
JournalActa Anaesthesiologica Scandinavica
Issue number5
Publication statusPublished - 2002
Publication categoryResearch

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