THE EFFECT OF EPIDURAL BLOCKADE ON GASTRIC INTRAMUCOSAL PH IN THE PERIOPERATIVE PERIOD

Patients undergoing major surgery are at risk of developing gut ischae mia and multiple organ failure. The gastric tonometer provides a relat ively non-invasive method of assessing the adequacy of gut blood flow. Patients who develop repeated episodes of splanchnic ischaemia in the postoperative period, as evidenced by a low gastric intramucosal pH, have a higher mortality than those who do not. This randomised, contro lled study was conducted to assess the effect of epidural blockade wit h bupivacaine on gastric intramucosal pH measurements in patients unde rgoing major surgery. A significantly lower proportion of patients wit h epidural blockade developed gastric intramucosal pH values < 7.32 po stoperatively compared to controls (3/15 versus 13/16, p < 0.001). The significance of these results is discussed.