Combined epidural‐general anaesthesia vs general anaesthesia in neonatal gastrointestinal surgery: A randomized controlled trial
| Autor: | Husein Khalaily, Sonia J. Vaida, Christopher Hadjittofi, Jalaa Hossein, Ibrahim Matter, Mostafa Somri, Lina Gannam-Somri |
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| Rok vydání: | 2019 |
| Předmět: |
Anesthesia
Epidural Male medicine.medical_specialty Ileus Anesthesia General law.invention 03 medical and health sciences Postoperative Complications 0302 clinical medicine Primary outcome Randomized controlled trial law medicine Humans General anaesthesia 030212 general & internal medicine Digestive System Surgical Procedures business.industry Infant Newborn Infant 030208 emergency & critical care medicine General Medicine University hospital medicine.disease Surgery Anesthesiology and Pain Medicine Parenteral nutrition Female Gastrointestinal function Complication business |
| Zdroj: | Acta Anaesthesiologica Scandinavica. 64:34-40 |
| ISSN: | 1399-6576 0001-5172 |
| DOI: | 10.1111/aas.13469 |
| Popis: | Background Post-operative ileus is a frequent complication of gastrointestinal surgery under general anaesthesia. The aim of this study was to investigate whether combined epidural-general anaesthesia is associated with expedited gastrointestinal function recovery in neonates undergoing elective gastrointestinal surgery. Methods A randomized controlled trial including 60 neonates who underwent gastrointestinal surgery at a university hospital was performed. Thirty neonates received combined epidural-general anaesthesia (CEGA), and 30 neonates received general anaesthesia (GA) alone. The primary outcome was the post-operative time to tolerance of full enteral nutrition. The secondary outcomes were the post-operative time defaecation, the duration of nasogastric drainage, and infections. Results After excluding two neonates from the CEGA group, where repeated attempts at epidural catheterization were unsuccessful, a total of 58 patients completed the study (CEGA: 28; GA: 30). Full enteral nutrition was tolerated earlier in CEGA vs the GA group (4.0 vs 8.0 days; P = .0001). Time to defaecation was shorter in the CEGA group (3.5 vs 5.0 days; P = .0001). Duration of nasogastric drainage was similar between groups (7.0 vs 7.0 days; P = .9502). Fewer patients in the CEGA group experienced post-operative infection (35.7% vs 60.0%; P = .038). Conclusion Combined epidural-general anaesthesia is associated with expedited gastrointestinal function recovery and a lower infection risk after gastrointestinal surgery in neonates. |
| Databáze: | OpenAIRE |
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