Retrospective Observational Study of Patient Outcomes With Local Wound Infusion vs Epidural Analgesia After Open Hepato-pancreato-biliary Surgery
| Autor: | Giuseppe Garcea, John Isherwood, Katherine Memory, Alexandra Claire Jackson, Philippa Graff-Baker, Eyad Issa |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Anesthesiology medicine Humans Pain Management RD78.3-87.3 Infusions Parenteral Anesthetics Local Digestive System Surgical Procedures Aged Retrospective Studies Pain Postoperative business.industry Research Hepato pancreato biliary Analgesia Patient-Controlled Wound infusion catheter Retrospective cohort study Length of Stay Middle Aged Surgery Analgesia Epidural Analgesics Opioid Treatment Outcome Anesthesiology and Pain Medicine Patient Satisfaction HPB surgery Epidural Female business |
| Zdroj: | BMC Anesthesiology BMC Anesthesiology, Vol 22, Iss 1, Pp 1-8 (2022) |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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