학술논문

Retrospective observational study of patient outcomes with local wound infusion vs epidural analgesia after open hepato-pancreato-biliary surgery.
Document Type
Article
Source
BMC Anesthesiology. 1/18/2022, Vol. 22 Issue 1, p1-8. 8p.
Subject
*EPIDURAL analgesia
*LENGTH of stay in hospitals
*NARCOTICS
*SCIENTIFIC observation
*ANALGESICS
*POSTOPERATIVE care
*RETROSPECTIVE studies
*TREATMENT effectiveness
*PATIENT-controlled analgesia
*ABDOMINAL surgery
*SURGICAL site
*ENTERAL feeding
DIGESTIVE organ surgery
Language
ISSN
1471-2253
Abstract
Background: Epidural analgesia is conventionally used as the mainstay of analgesia in open abdominal surgery but has a small life-changing risk of complications (epidural abscesses or haematomas). Local wound-infusion could be a viable alternative and are associated with fewer adverse effects. Methods: A retrospective observational analysis of individuals undergoing open hepato-pancreato-biliary surgery over 1 year was undertaken. Patients either received epidural analgesia (EP) or continuous wound infusion (WI) + IV patient controlled anaesthesisa (PCA) with an intraoperative spinal opiate. Outcomes analyzed included length of stay, commencement of oral diet and opioid use. Results: Between Jan 2016- Dec 2016, 110 patients were analyzed (WI n=35, EP n=75). The median length of stay (days) was 8 in both the WI and EP group (p=0.846), the median time to commencing oral diet (days) was 3 in WI group and 2 in EP group (p=0.455). There was no significant difference in the amount of oromorph, codeine or tramadol (mg) between WI and EP groups (p=0.829, p=0.531, p=0.073, respectively). Conclusions: Continuous wound infusion + IV PCA provided adequate analgesia to patients undergoing open hepato-pancreato-biliary surgery. It was non-inferior to epidural analgesia with respect to hospital stay, commencement of oral diet and opioid use. [ABSTRACT FROM AUTHOR]