Iliescu L.,Hospital Colentina
Archives of the Balkan Medical Union | Year: 2011
Background: This study was realized in order to compare effects of postoperative epidural opioids with systemic opioids on post-operative recovery after major abdominal surgery. The effect on postoperative recovery was evaluated in terms of pain intensity, duration of postoperative ileus, incidence of postoperative complications and length of hospital stay. Methods: The prospective, nonrandomized, clinical comparison study enrolled 85 patients ASA II-III divided in two groups: the EA group (44 patients) who received postoperative epidural analgesia and the IA group (41 patients) who received intravenous analgesia. In both groups in case of a VAS pain score ≥ 4, supplemental intravenous analgesia was given. Recorded data: quality of analgesia (VAS pain score), analgesic administration (standard and supplemental requirements of analgesics), post-operative evolution (need/ duration of postoperative ventilatory support, day of active mobilization, day of first flatus), adverse reactions of every method and hospital stay. Results: There were no significant differences between both groups regarding age, sex, comorbidities, malignancy incidence, type of surgical procedure and ASA score (p=0.48-0.82). The mean pain score was significantly lower in EA group (2.01±1.0) compared with IA group (3.29±0.8) (p<0.001). The need (p=0.365) and duration (p=0.8) of postoperative ventilatory support were similar. In the EA group active mobilization and first flatus were recorded earlier then in IA group (p=0.03, respectively p < 0.001). On the other hand, EA was associated with a significant increase in the incidence of pruritus (15.3%), urinary retention (13.9%) and arterial hypotension (13%). EA did not influence duration of hospital stay. Conclusions: Despite improved postoperative pain relief and a decrease in ileus, epidural analgesia has no proven benefit regarding length of stay. Copyright © 2011 CELSIUS.