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Clinical Trial
. 2001 Oct;234(4):560-9; discussion 569-71.
doi: 10.1097/00000658-200110000-00015.

Effect of epidural anesthesia and analgesia on perioperative outcome: a randomized, controlled Veterans Affairs cooperative study

W Y Park  1 , J S Thompson, K K Lee
Affiliations
Clinical Trial

Effect of epidural anesthesia and analgesia on perioperative outcome: a randomized, controlled Veterans Affairs cooperative study

W Y Park et al. Ann Surg. 2001 Oct.

Abstract

Objective: To test the hypothesis that epidural anesthesia and postoperative epidural analgesia decrease the incidence of death and major complications during and after four types of intraabdominal surgical procedures.

Summary background data: Even though many beneficial aspects of epidural anesthesia have been reported, clinical trials of epidural anesthesia for outcome of surgical patients have shown conflicting results.

Methods: The authors studied 1,021 patients who required anesthesia for one of the intraabdominal aortic, gastric, biliary, or colon operations. They were assigned randomly to receive either general anesthesia and postoperative analgesia with parenteral opioids (group 1) or epidural plus light general anesthesia and postoperative epidural morphine (group 2). The patients were monitored for death and major complications during and for 30 days after surgery, as well as for postoperative pain, time of ambulation, and length of hospital stay.

Results: Overall, there was no significant difference in the incidence of death and major complications between the two groups. For abdominal aortic surgical patients, unlike the other three types of surgical patients, the overall incidence of death and major complications was significantly lower in group 2 patients (22%) than in group 1 patients (37%), stemming from differences in the incidence of new myocardial infarction, stroke, and respiratory failure between the two groups. Overall, group 2 patients received significantly less analgesic medication but had better pain relief than group 1 patients. In group 2 aortic patients, endotracheal intubation time was 13 hours shorter and surgical intensive care stay was 3.5 hours shorter.

Conclusions: The effect of anesthetic and postoperative analgesic techniques on perioperative outcome varies with the type of operation performed. Overall, epidural analgesia provides better postoperative pain relief. Epidural anesthesia and epidural analgesia improve the overall outcome and shorten the intubation time and intensive care stay in patients undergoing abdominal aortic operations.

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References

    1. Enquist A, Brandt MR, Fernandes A, et al. The blocking effect of epidural analgesia on the adrenocortical and hyperglycemic response to surgery. Acta Anesth Scand 1977; 21: 330–335. - PubMed
    1. Brandt MR, Fernandes A, Mordhost R, et al. Epidural analgesia improves postoperative nitrogen balance. Br Med J 1978; 1: 1106–1108. - PMC - PubMed
    1. Yeager MP, Glass DD, Neff RK, et al. Epidural anesthesia and analgesia in high-risk surgical patients. Anesthesiology 1987; 66: 729–736. - PubMed
    1. Park WY, Poon KC, Macnamara TE. Epidural block for lumbar laminectomy. Reg Anesth 1987; 12: 48–49.
    1. Modig J, Karlstrom G. Intra- and post-operative blood loss and hemodynamics in total hip replacement when performed under lumbar epidural versus general anesthesia. Eur J Anesthesiol 1987; 4: 345–355. - PubMed

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