The Role of Epidural Anesthesia and Analgesia in Surgical Practice

Overview

Journal Ann Surg

Specialty General Surgery

Date 2003 Oct 28

PMID 14578727

Citations 89

Authors

Robert J Moraca

David G Sheldon

Richard C Thirlby

Affiliations

Soon will be listed here.

Abstract

Objective: To review the potential and proven benefits and complications of epidural anesthesia/analgesia.

Summary Background Data: Advances in analgesia/anesthesia have improved patient satisfaction and perioperative outcomes. Epidural anesthesia/analgesia is one of these advances that is gaining rapid acceptance due to a perceived reduction in morbidity and overall patient satisfaction.

Methods: A MEDLINE search was conducted for all pertinent articles on epidural anesthesia/analgesia.

Results: Retrospective, prospective, and meta-analysis studies have demonstrated an improvement in surgical outcome through beneficial effects on perioperative pulmonary function, blunting the surgical stress response and improved analgesia. In particular, significant reduction in perioperative cardiac morbidity ( approximately 30%), pulmonary infections ( approximately 40%), pulmonary embolism ( approximately 50%), ileus ( approximately 2 days), acute renal failure ( approximately 30%), and blood loss ( approximately 30%) were noted in our review of the literature. Potential complications related to epidural anesthesia/analgesia range from transient paresthesias (<10%) to potentially devastating epidural hematomas (0.0006%).

Conclusions: Epidural anesthesia/analgesia has been demonstrated to improve postoperative outcome and attenuate the physiologic response to surgery.

Citing Articles

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Ultrasound-Guided Epidural Anaesthesia in a 73-Year-Old Female With Bilateral Osteoarthritis and a History of Difficult Epidural Placement: A Case Report.

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Wan J, Lin C, Wu Z, Feng D, Wang Y, Wang F Front Med (Lausanne). 2024; 11:1413191.

PMID: 39161411 PMC: 11330782. DOI: 10.3389/fmed.2024.1413191.

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