Effect of epidural and general anaesthesia compared with general anaesthesia alone in large bowel anastomoses. A prospective study

Abstract

Objective: To find out whether patients did better after operations that entailed a large bowel anastomosis if they were given combined epidural and general anaesthesia with spontaneous ventilation rather than standard general anaesthesia with muscle relaxation and ventilation.

Design: Prospective randomised trial.

Setting: Specialist unit, teaching hospital.

Subjects: 80 patients undergoing large bowel anastomoses.

Main outcome measures: Incidence of chest infection, wound infection, anastomotic breakdown, urinary tract infection, deep vein thrombosis, pulmonary embolism, median hospital stay and death.

Results: There were no differences between the groups, but the results were better during the trial period (1985-89) than during the period 1978-83.

Conclusion: Factors that influence anastomotic healing are complex and improved surgical techniques, postoperative monitoring and patient care may account for the improvement in results compared with the earlier period.