Prolonged epidural analgesia during perioperative period in patients undergone laparoscopic surgery on gastrointestinal tract

Abstract

The study focused on the role of prolonged epidural analgesia in complex multimodal analgesia while performing major laparoscopic surgery. The results of evaluation of intensity of postoperative pain, post-operative physical activity and the dynamics of the parameters of central hemodynamics and respiratory function were compared in two subgroups: study group included patients operated under combined and balanced general anesthesia; the control group included patients who had undergone similar in terms of the intervention laparotomy. The results of the study demonstrated reduction of the pain and acceleration of mobilization in patients treated according the pain relief scheme which included epidural analgesia; under the influence of the latter mentioned earlier recovery of baseline blood circulation and respiration.

Keywords

epidural analgesia / laparoscopic surgery / perioperative analgesia

References

[1] Kehlet H., Kennedy R. H. Laparosopic colonic surgery- mission accomplished or work in progress? Colorectal Dis. 2006; 8: 514-517.

[2] Kitching A. J., O’Neil S. S. Fast-track surgery and anesthesia. Contin. Educ. Anesth. Crit. Care Pain. 2009; 9(2): 39-43.

[3] Xiong J. J., Nunes Q. M., Huang W., Tan C. L. et al. Laparoscopic vs open total gastrectomy for gastric cancer: A meta-analysis. World J. Gastroenterol. 2013 Nov; 28; 19(44): 8114-8132.

[4] Malbrain M. L., Cheatham M. L., Kirkpatrick A., Sugrue M. et al. Results from the international conference of experts on intra-abdominal hypertension and abdominal compartment syndrome. I. Definitions. Intens Care Med. 2006; 32: 1722-1732.

[5] Navarro D. C., Fuertes M. J., Riquelme A. I. Laparoscopic appendectomy: quality care and cost-effectiveness for today’s economy. World J Emerg Surg. 2013 Nov; 8(1): 45.

[6] Schlachta C. M., Mamazza J., Seshadri P. A., Cadeddu M. et al. Defining a learning curve for laparoscopic colonic resections. Dis. Colon Rectum. 2011 Feb; 44(2): 217-222.

[7] Chanques G., Viel E., Constantin J. M. et al: The measurement of pain in intensive care unit: Comparison of 5 self-report intensity scales. Pain. 2010; 151: 711-721.

[8] Walsh B. K., Crotwell D. N., Restrepo R. D. Capnography (capnometry) during mechanical ventilation: 2011. Respir. Care. 2011: 56(4): 503-509.

[9] Gustafsson U. O., Scott M. J., Schwenk W., Demartines N. et al. Guidelines for Perioperative Care in Elective Colonic Surgery: Enhanced Recovery After Surgery (ERAS®) Society Recommendations. World Journal of Surgery. 2012 Feb; 37(2): 259-284.

[10] Lassen K., Coolsen M. M. E., Slim K., Carli F. et al. Guidelines for Perioperative Care for Pancreaticoduodenectomy: Enhanced Recovery After Surgery (ERAS®) Society Recommendations. Clin Nutr. 2013 Oct; 32(5): 870-871.

[11] Nygren J., Thacker J., Carli F., Fearon K. C. H. et al. Guidelines for Perioperative Care in Elective Rectal/Pelvic Surgery: Enhanced Recovery After Surgery (ERAS®) Society Recommendations. World Journal of Surgery. 2013 Feb; 37(2): 285-305.

[12] Shabir S. A., Saleem B., Hakim A., Hashia A. M. Postoperative Analgesia In Laparoscopic Cholecystectomy: A Comparative Study Using Bupivacaine Instillation And Infiltration Versus Parenteral Analgesia (Tramadol). Int J Anesth. 2011; 29(2).

RIGHTS & PERMISSIONS

Eco-Vector