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

Figure 1 CONSORT diagram showing randomization and allocation of the study cohort.

Figure 2 Perfusion computed tomography color map and standard computed tomography of the pancreas obtained in a 75-year-old woman admitted for acute severe pancreatitis, randomized to group 1 (epidural anesthesia). A: Axial image obtained at admission shows a positive enhancement integral (PEI) value of 15.9 in the pancreatic body; B: Axial image obtained with control computed tomography (CT), 72 h after admission, shows a 29% improvement of the perfusion in the pancreatic body (PEI of 20.5) when compared to admission values; C: Standard CT axial oblique image at the level of the pancreas obtained on admission, during portal phase.

Figure 3 Perfusion computed tomography color map and standard computed tomography of the pancreas obtained in a 73-year-old man admitted for acute severe pancreatitis, randomized to group 2 (control group). A: Axial image obtained on admission shows a positive enhancement integral (PEI) value of 16.5 in the pancreatic head; B: Axial image obtained with control computed tomography (CT), 72 h after admission, shows a 53% impairment of the perfusion in the pancreatic head (PEI of 7.8) when compared to admission values; C: Standard CT axial oblique image, at the level of the pancreas obtained on admission, during portal phase.

Figure 4 Changes in pancreatic perfusion measurements at 72 h compared to the measurements. On admission in the epidural anesthesia (EA) and control group (significant increase, decrease or no change in perfusion). ^aP = 0.0025 vs control.