Epidural analgesia in colonic surgery: Results of a randomized prospective study
Article first published online: 8 DEC 2005
Copyright © 1990 British Journal of Surgery Society Ltd.
British Journal of Surgery
Volume 77, Issue 6, pages 638–642, June 1990
How to Cite
Bredtmann, R. D., Herden, H. N., Teichmann, W., Moecke, H. P., Kniesel, B., Baetgen, R. and Tecklenburg, A. (1990), Epidural analgesia in colonic surgery: Results of a randomized prospective study. Br J Surg, 77: 638–642. doi: 10.1002/bjs.1800770615
- Issue published online: 8 DEC 2005
- Article first published online: 8 DEC 2005
- Manuscript Accepted: 16 JAN 1990
- Colonic surgery;
- continuous epidural analgesia;
- postoperative morbidity
Colonic surgery patients were studied to measure: the influence of continuous thoracic epidural analgesia (TEA) on a postoperative pain score, the time till onset of defaecation, blood loss, postoperative temperature elevations, rate of bacterial contamination of wounds and urine, and general surgical complications. Group I patients (n = 57) received general anaesthesia and TEA for the operation, followed by continuous TEA (0·25 per cent bupivacaine) for 72 h. Group IIpatients (n = 59) received general anaesthesia for the operation, followed by systemic analgesia on request. Significant beneficial effects of TEA in group I were demonstrated by lower pain scores in the first 24 h after surgery and earlier defaecation. However, there were fewer temperature elevations in group II. There was no significant difference between the groups in terms of positive bacteriological cultures, blood loss, need for postoperative mechanical ventilation and complications. However, there was a trend toward a higher rate of rectal anastomotic breakdown, increased blood replacement and intensive care therapy, and longer hospitalization in group I. These results do not suggest any significant beneficial therapeutic effect of continuous TEA in colonic surgery compared with a conventional systemic analgesic regimen. In selected patients (i.e. those with severe pain or those prone to develop postoperative ileus) continuous TEA may be beneficial.