Camargo Michel Gardere, Fagundes João José, Leal Raquel Franco, Ayrizono Maria de Lourdes Setsuko, Rossi Débora Helena dos Gonçalves, Oliveira Priscilla de Sene Portel, Chung Wu Feng, Lee Huei Diana, Coy Cláudio Saddy Rodrigues
Acta Cir Bras. 2013 Nov;28(11):783-7. doi: 10.1590/s0102-86502013001100007.
To evaluate the effects of peritoneal lavage with bupivacaine on survival and initial resistance of anastomosis on distal colon, performed under peritonitis or not.
Forty rats, weighing from 300 to 350 g (321.29 ± 11.3 1g), were randomly divided in four groups and underwent laparotomy and anastomosis on the distal colon six hours after induction of peritonitis by intraperitoneal injection of autologous fecal material or not. Group 1: No peritonitis and lavage with 3 ml NS; Group 2: No peritonitis and lavage with 8 mg.kg-1 (± 0.5 mL) of 0.5% bupivacaine added to 2.5 mL of NS; Group 3: Peritonitis and lavage with 3 ml NS; Group 4: Peritonitis and lavage with 8 mg.kg-1 (± 0.5 mL) of 0.5% bupivacaine added to 2.5 mL of NS. Necropsies were performed on the animals that died and the time of death was recorded. Surviving animals were submitted to euthanasia on the fifth post-operative day and Total Energy of Rupture biomechanical test (TER) was applied.
Group 4 showed survival increase compared to Group 3, without statistical significance. Group 3 presented the smallest average TER, with statistical significance.
Peritonitis increased mortality and influenced negatively the resistance of colic anastomosis in rats. Peritoneal lavage with bupivacaine increased anastomotic resistance.
评估布比卡因腹腔灌洗对在有或无腹膜炎情况下进行的远端结肠吻合口存活及初始抗张强度的影响。
40只体重300至350克（321.29±11.31克）的大鼠被随机分为四组，在通过腹腔注射自体粪便物质诱导腹膜炎6小时后或未诱导腹膜炎的情况下，进行剖腹术及远端结肠吻合术。第1组：无腹膜炎，用3毫升生理盐水灌洗；第2组：无腹膜炎，用添加到2.5毫升生理盐水中的8毫克/千克（±0.5毫升）0.5%布比卡因灌洗；第3组：有腹膜炎，用3毫升生理盐水灌洗；第4组：有腹膜炎，用添加到2.5毫升生理盐水中的8毫克/千克（±0.5毫升）0.5%布比卡因灌洗。对死亡动物进行尸检并记录死亡时间。存活动物在术后第5天接受安乐死，并进行破裂总能量生物力学测试（TER）。
与第3组相比，第4组显示存活率增加，但无统计学意义。第3组的平均TER最小，具有统计学意义。
腹膜炎增加了大鼠的死亡率，并对结肠吻合口的抗张强度产生负面影响。布比卡因腹腔灌洗增加了吻合口抗张强度。
