PURPOSE: The optimal analgesia following laparoscopic distal gastrectomy (LDG) has not been determined; moreover, it has been unclear whether epidural anesthesia has benefits for laparoscopic surgery. In this study, we evaluated the effectiveness of epidural analgesia after LDG. METHODS: This retrospective study included 84 patients who underwent LDG for gastric cancer. Patients received either combined thoracic epidural and general anesthesia (Epidural group, n = 34) or general anesthesia alone (No epidural group, n = 50). We recorded data on the patients, surgery, postoperative outcomes and anesthesia-related complications. RESULTS: In the Epidural group, the first day of flatus was significantly earlier (2.21 vs. 2.44 days, p = 0.045) and the number of additional doses of analgesics was significantly lower (2.85 vs. 4.86 doses, p = 0.007) than in the No epidural group. Postoperative urinary retention occurred at a significantly higher rate in the Epidural group (n = 7; 20.6 %) than in the No epidural group (p < 0.001). CONCLUSION: Epidural anesthesia may reduce the need for additional analgesics after LDG, but increases the risk of urinary retention.
PURPOSE: The optimal analgesia following laparoscopic distal gastrectomy (LDG) has not been determined; moreover, it has been unclear whether epidural anesthesia has benefits for laparoscopic surgery. In this study, we evaluated the effectiveness of epidural analgesia after LDG. METHODS: This retrospective study included 84 patients who underwent LDG for gastric cancer. Patients received either combined thoracic epidural and general anesthesia (Epidural group, n = 34) or general anesthesia alone (No epidural group, n = 50). We recorded data on the patients, surgery, postoperative outcomes and anesthesia-related complications. RESULTS: In the Epidural group, the first day of flatus was significantly earlier (2.21 vs. 2.44 days, p = 0.045) and the number of additional doses of analgesics was significantly lower (2.85 vs. 4.86 doses, p = 0.007) than in the No epidural group. Postoperative urinary retention occurred at a significantly higher rate in the Epidural group (n = 7; 20.6 %) than in the No epidural group (p < 0.001). CONCLUSION: Epidural anesthesia may reduce the need for additional analgesics after LDG, but increases the risk of urinary retention.
Authors: Deok Gie Kim; Yoon Young Choi; Ji Yeong An; In Gyu Kwon; In Cho; Yoo Min Kim; Jung Min Bae; Myung Gyu Song; Sung Hoon Noh Journal: Surg Endosc Date: 2013-03-14 Impact factor: 4.584