[Epidural Analgesia in Minimally Invasive Esophagectomy: Evidence and Practice]

Abstract

Esophagectomy is an effective treatment for esophageal cancer, and there has been growing attention on the importance of postoperative pain management in patients undergoing the surgery. Epidural analgesia is the preferred analgesic approach for open esophagectomy. With the development of surgical technology, minimally invasive esophagectomy (MIE) has become the mainstream surgical approach. However, no conclusion has been reached concerning whether epidural analgesia is still the preferred analgesic approach for MIE. Herein, we analyzed the relevant literature published in recent years and found that epidural analgesia continued to be an important analgesic approach for MIE, offering the best analgesic effect. Epidural analgesia can reduce postoperative pulmonary complications, improve the quality of life, and reduce the stress response. Adverse effects can be minimized through accurate selection of epidural puncture segments, individualized medication, and multimodal analgesia strategies. In the future, precision-based multimodal analgesia can be achieved using emerging technologies such as big data analytics and artificial intelligence.

Keywords: Analgesia, epidural; Complications; Esophagectomy; Minimally invasive surgical procedures; Review.

图 1

Application of epidural analgesia in minimally invasive esophagectomy in Sankey diagram visualization 硬膜外镇痛在MIE术中应用相关文献桑基图 RCT: randomized controlled trial; MIE: minimally invasive esophagectomy.

图 2

A comparative study of different analgesic methods in MIE 不同镇痛方式在MIE术后镇痛的对照研究 The size of the nodes corresponds to the sample size of the study. The lines linking the nodes represent the comparison of the two analgesic methods. The thicker the line, the more published reports comparing the two analgesic methods.