scholarly journals Intraoperative Management of Combined General Anaesthesia and Thoracic Epidural Analgesia: A Survey Among German Anaesthetists

2021 ◽  
Author(s):  
Tobias Schlesinger ◽  
Stephanie Weibel ◽  
Thorsten Steinfeldt ◽  
Magdalena Sitter ◽  
Patrick Meybohm ◽  
...  
Keyword(s):  
Epidural Analgesia ◽  
General Anaesthesia ◽  
Thoracic Epidural Analgesia ◽  
Thoracic Epidural ◽  
Intraoperative Management

scholarly journals Beneficial Effects of thoracic epidural anaesthesia on mortality after elective surgery for colon cancer: a survey of 215 consecutive patients

2019 ◽  
Author(s):  
Simon Moormann ◽  
Marie Luise Rübsam ◽  
Eva Warnking ◽  
Antje Gottschalk ◽  
Klaus Hahnenkamp ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Epidural Analgesia ◽  
General Anaesthesia ◽  
Cancer Recurrence ◽  
Thoracic Epidural Analgesia ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Thoracic Epidural ◽  
Short And Long Term

Abstract Background: Colorectal cancer is a major cause of death in the industrial world. The mortality and morbidity rates depend on the incidence of postoperative complications and cancer recurrence. Data from basic science support the view that regional anaesthesia reduces perioperative stress levels, potentially resulting in a lower risk of complications and cancer relapse. Methods:  In 215 patients underwent open colon cancer surgery, carried out by the same visceral surgeon and the same oncologist we compared short and long-term outcome data for 83 patients with general anaesthesia plus thoracic epidural analgesia (EPI group) and for 132 patients with general anaesthesia alone (GA group). Oncological data from a state-wide follow-up database were included. The effects of different perioperative anaesthetic techniques on patients’ short and long-term outcome (36 month) were statistically analysed (Kaplan Meyer Curve, Pearson’s chi-squared test, Student’s t-test, and the Wilcoxon rank sum test, as appropriate). Results: With the exception of a significantly higher prevalence of arterial hypertension in the EPI group in comparison with the GA group, there were no differences in demographic, tumour staging data and cancer recurrence rates between the groups. However, mortality rates were significantly different between the groups. 37 of 132 GA patients (28%) died within 36 months, in comparison with 14 of 83 EPI patients (16.9%, P < 0.05). Patients over the age of 70 in particular significantly benefited from perioperative epidural analgesia and had a significantly better survival compared with patients without perioperative epidural analgesia (p<0.05). Discussion: Perioperative use of epidural analgesia reduces the 36-month postoperative mortality rate. This effect may be due to systemic effects of local anaesthetics or to a reduced stress response caused by the thoracic epidural analgesia itself. Conclusions: Patients with colon cancer over the age of 70 in particular significantly benefited from perioperative epidural analgesia and had a longer survival time in comparison with patients without perioperative epidural analgesia. (ISRCTN10994336, retrospective registered 07/06/2019)

The effects of thoracic epidural analgesia combined with general anaesthesia in OPCABG patients

2002 ◽  
Vol 19 (Supplement 27) ◽  
pp. 27
Author(s):  
S. Goren ◽  
F. N. Kaya ◽  
E. B. Mogol ◽  
S. Sahin ◽  
G. Korfali ◽  
...  
Keyword(s):  
Epidural Analgesia ◽  
General Anaesthesia ◽  
Thoracic Epidural Analgesia ◽  
Thoracic Epidural

Paravertebral Block versus Thoracic Epidural Analgesia for Postthoracotomy Pain Relief: A Meta-Analysis of Randomized Trials

2021 ◽  
Author(s):  
Mu Xu ◽  
Jiajia Hu ◽  
Jianqin Yan ◽  
Hong Yan ◽  
Chengliang Zhang
Keyword(s):  
Side Effects ◽  
Pain Relief ◽  
Epidural Analgesia ◽  
Meta Analysis ◽  
Thoracic Epidural Analgesia ◽  
Paravertebral Block ◽  
Cochrane Library ◽  
Thoracic Epidural ◽  
Analgesic Consumption ◽  
Postthoracotomy Pain

Abstract Objective Paravertebral block (PVB) and thoracic epidural analgesia (TEA) are commonly used for postthoracotomy pain management. The purpose of this research is to evaluate the effects of TEA versus PVB for postthoracotomy pain relief. Methods A systematic literature search was conducted in PubMed, EMBASE, Web of Science, and the Cochrane Library (last performed on August 2020) to identify randomized controlled trials comparing PVB and TEA for thoracotomy. The rest and dynamic visual analog scale (VAS) scores, rescue analgesic consumption, the incidences of side effects were pooled. Results Sixteen trials involving 1,000 patients were included in this meta-analysis. The pooled results showed that the rest and dynamic VAS at 12, 24, and rest VAS at 48 hours were similar between PVB and TEA groups. The rescue analgesic consumption (weighted mean differences: 3.81; 95% confidence interval [CI]: 0.982–6.638, p < 0.01) and the incidence of rescue analgesia (relative risk [RR]: 1.963; 95% CI: 1.336–2.884, p < 0.01) were less in TEA group. However, the incidence of hypotension (RR: 0.228; 95% CI: 0.137–0.380, p < 0.001), urinary retention (RR: 0.392; 95% CI: 0.198–0.776, p < 0.01), and vomiting (RR: 0.665; 95% CI: 0.451–0.981, p < 0.05) was less in PVB group. Conclusion For thoracotomy, PVB may provide no superior analgesia compared with TEA but PVB can reduce side effects. Thus, individualized treatment is recommended. Further study is still necessary to determine which concentration of local anesthetics can be used for PVB and can provide equal analgesic efficiency to TEA.

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