scholarly journals Current opinion in epidural analgesia influence on incidence of complications after major abdominal surgery

2007 ◽  
Vol 54 (2) ◽  
pp. 105-108
Author(s):  
D.M. Stamenkovic ◽  
V.I. Rankovic ◽  
Z.V. Slavkovic ◽  
M. Ostojic
Keyword(s):  
Postoperative Pain ◽  
Abdominal Surgery ◽  
Current Knowledge ◽  
Postoperative Recovery ◽  
Review Article ◽  
Major Abdominal Surgery ◽  
Chronic Postoperative Pain ◽  
Current Opinion ◽  
Thoracic Epidural ◽  
Acute Rehabilitation

Review article summarizes current knowledge of general and epidural anesthesia combination for major abdominal surgery and incidence of postoperative complications. Continuous epidural local anesthetics especially through thoracic placed epidural catheter decrease opioids use and as part of "acute rehabilitation" plays important role in postoperative recovery. Most of the studies showed cognition is not dependent on kind of anesthesia and analgesia. Successfully treated postoperative pain prevents chronic postoperative pain, which is best achieved in abdominal surgery with thoracic epidural use. .

scholarly journals Controlo de Dor, Infeção Local, Satisfação, Efeitos Adversos e Dor Residual no Pós-Operatório de Cirurgia Abdominal Major: Epidural versus Infusão Contínua da Ferida Cirúrgica (PAMA Trial)

2017 ◽  
Vol 30 (10) ◽  
pp. 683 ◽  
Author(s):  
Rita Araújo ◽  
Céline Marques ◽  
David Fernandes ◽  
Emanuel Almeida ◽  
Joana Alves ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Abdominal Surgery ◽  
Epidural Analgesia ◽  
Postoperative Analgesia ◽  
Standard Technique ◽  
Hemodynamic Instability ◽  
Pain Scale ◽  
Major Abdominal Surgery ◽  
Continuous Epidural Infusion ◽  
Infusion Group

Introduction: The Management of postoperative pain after abdominal surgery is a major challenge to the anesthesiologist. The optimization of postoperative analgesia improves prognosis contributing also to patient satisfaction and reducing morbidity and mortality. The aim of this randomized control study is to perform the comparative analysis in terms of effectiveness of an unconventional and still poorly technique implemented, continuous wound infusion, and the currently most applied and gold standard technique, epidural analgesia, in the postoperative period after abdominal surgery.Material and Methods: Fifty patients, previously subjected to abdominal surgery by median laparotomy with xifo-pubic incision were randomized to receive postoperative analgesia via epidural (n = 25) or via continuous wound infusion (n = 25) during 48 hours. The primary outcome was analysis of pain at rest (< 4/10 numerical pain scale) after 24 hours postoperatively. Scores of pain at six, 12 and 48 hours and three months after surgery were also evaluated, as well as the incidence of adverse effects 48 hours postoperatively.Results: The proportion of patients with successful control of postoperative pain was 84% against 60% with epidural analgesia and continuous wound infusion, respectively. Within the continuous wound infusion group with uncontrolled pain, all patients rated the pain below 6/10 24 hours postoperatively. The incidence of nausea, vomiting, pruritus or íleus was lower in the continuous wound infusion group, with statistically significant results for recovery of intestinal function. There was one case of systemic local anesthetic toxicity with an episode of frequent ventricular extrasystoles without hemodynamic instability, which ceased after suspension of continuous epidural infusion of local anesthetic.Discussion: This study suggests that continuous wound infusion is the technique with most efficacy and safety, being even better than epidural analgesia in postoperative pain control after major abdominal surgery. This technique is associated with better analgesia, lower incidence of side effects, high level of satisfaction and no residual pain, contributing to enhanced recovery.Conclusion: Continuous wound infusion is an effective technique, which should be implemented for analgesia after major abdominal surgery, with advantages when compared with epidural analgesia, especially low incidence of adverse effects.Registration: Trial not registered.

Thoracic Epidural Anesthesia Improves Tissue Oxygenation during Major Abdominal Surgery

2002 ◽  
Vol 96 (Sup 2) ◽  
pp. A191
Author(s):  
Barbara Kabon ◽  
Edith Fleischmann ◽  
Akiko Taguchi ◽  
Stefan Kapral ◽  
Andrea Kurz
Keyword(s):  
Abdominal Surgery ◽  
Epidural Anesthesia ◽  
Tissue Oxygenation ◽  
Major Abdominal Surgery ◽  
Thoracic Epidural Anesthesia ◽  
Thoracic Epidural
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