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Epidural analgesia in open resection of colorectal cancer: is there a clinical benefit? a retrospective study on 1,470 patients.
- Source :
- Journal of Gastrointestinal Surgery; Aug2011, Vol. 15 Issue 8, p1386-1393, 8p
- Publication Year :
- 2011
-
Abstract
- <bold>Background: </bold>Epidural analgesia (EA) is effective for postoperative pain relief and results in an earlier recovery from postoperative paralytic ileus. This study evaluated the influence of epidural analgesia on the postoperative 30-day mortality and morbidity after open colorectal cancer resection.<bold>Methods: </bold>A retrospective observational study was performed at a single, tertiary hospital. All patients with an open colorectal cancer surgery between 1991 and 2008 were identified from the hospital database.<bold>Results: </bold>Of the 1,470 patients included in the study, 838 (57.0%) received an EA. Mortality was lower after EA (1.5% vs. 5.7%, p < 0.001). Risk of pneumonia was reduced after EA (odds ratio (OR), 0.45; 95% confidence interval (CI), 0.28-0.74; p = 0.001), but not the risk of anastomotic leakage (OR, 1.18; 95% CI, 0.76-1.81; p = 0.465) or surgical site infections (OR, 1.09; 95% CI, 0.74-1.60; p = 0.663). A subgroup analysis of 427 patients operated on after 2002 (reflecting improved perioperative management) yielded similar results. However, no significant reduction in mortality was observed in the subgroup analysis.<bold>Conclusion: </bold>For patients with open colorectal cancer surgery, the application of EA leads to a reduction in pneumonia. Although this is only a retrospective study, it strongly supports the use of EA. [ABSTRACT FROM AUTHOR]
- Subjects :
- COLON cancer
COLON surgery
ANALGESIA
POSTOPERATIVE pain treatment
DRUG efficacy
RETROSPECTIVE studies
MEDICAL records
MEDICAL statistics
PNEUMONIA
LOCAL anesthetics
THERAPEUTIC use of narcotics
ANALGESICS
FENTANYL
BUPIVACAINE
AGE distribution
COLON tumors
RECTUM tumors
REGRESSION analysis
SURGICAL complications
SURGICAL site infections
DISEASE incidence
EPIDURAL analgesia
THERAPEUTICS
Subjects
Details
- Language :
- English
- ISSN :
- 1091255X
- Volume :
- 15
- Issue :
- 8
- Database :
- Complementary Index
- Journal :
- Journal of Gastrointestinal Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 63235039
- Full Text :
- https://doi.org/10.1007/s11605-011-1582-y