Purpose: Postoperative complications after major liver surgery are common. Thoracic epidural anesthesia may provide beneficial effects on postoperative outcome. We strove to compare postoperative outcomes in major liver surgery patients with and without thoracic epidural anesthesia.
Methods: This was a retrospective cohort study in a single university medical center. Patients undergoing elective major liver surgery between April 2012 and December 2016 were eligible for inclusion. We divided patients into two groups according to whether or not they had thoracic epidural anesthesia for major liver surgery. The primary outcome was postoperative hospital length of stay, i.e., from day of surgery until hospital discharge. Secondary outcomes included 30-day postoperative mortality and major postoperative complications. Additionally, we investigated the effect of thoracic epidural anesthesia on perioperative analgesia doses and the safety of thoracic epidural anesthesia.
Results: Of 328 patients included in this study, 177 (54.3%) received thoracic epidural anesthesia. There were no clinically important differences in postoperative hospital length of stay (11.0 [7.00-17.0] vs. 9.00 [7.00-14.0] days, p = 0.316, primary outcome), death (0.0 vs. 2.7%, p = 0.995), or the incidence of postoperative renal failure (0.6 vs. 0.0%, p = 0.99), sepsis (0.0 vs. 1.3%, p = 0.21), or pulmonary embolism (0.6 vs. 1.4%, p = 0.59) between patients with or without thoracic epidural anesthesia. Perioperative analgesia doses - including the intraoperative sufentanil dose (0.228 [0.170-0.332] vs. 0.405 [0.315-0.565] μg·kg·h, p < 0.0001) - were lower in patients with thoracic epidural anesthesia. No major thoracic epidural anesthesia-associated infections or bleedings occurred.
Conclusion: This retrospective analysis suggests that thoracic epidural anesthesia does not reduce postoperative hospital length of stay in patients undergoing major liver surgery - but it may reduce perioperative analgesia doses. Thoracic epidural anesthesia was safe in this cohort of patients undergoing major liver surgery. These findings need to be confirmed in robust clinical trials.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10148777 | PMC |
| http://dx.doi.org/10.1007/s00423-023-02900-w | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Abscess and aneurysm: A case of tuberculous abscess causing an aortic pseudo-aneurysm.
Radiol Case Rep
March 2025
Maimonides Medical Center, Brooklyn, NY, USA.
Thoracic aortic pseudoaneurysms are a rare but serious complication of infectious processes, often resulting from mycotic (infectious) aneurysms, occurring when the vessel wall is compromised by an infection, leading to the formation of a pseudoaneurysm [1]. Mycotic aneurysms typically result from bacteremia or fungemia, with common sources being infective endocarditis or other systemic infections. Tuberculosis, though a common infectious disease worldwide, is an unusual cause of aortic pseudoaneurysm formation.
View Article and Find Full Text PDFAntithrombotic prophylaxis use and incidence of venous thromboembolism in lung cancer surgery: An observational retrospective study.
Cir Esp (Engl Ed)
January 2025
Hematology Service, Clínica Universidad de Navarra, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IDISNA), Pamplona, Spain. Electronic address:
Introduction: Extended thromboprophylaxis with low-molecular-weight heparin (LMWH) for 28 days is recommended in patients undergoing major abdominal or pelvic cancer surgery, but the evidence for thoracic cancer surgery is weak. We aimed to evaluate the use of pharmacological thromboprophylaxis and incidence of venous thromboembolism (VTE) in adult patients undergoing lung cancer surgery in daily clinical practice.
Methods: Retrospective evaluation of a cohort of consecutive adult patients who had undergone lung cancer surgery.
Hologram-assisted thoracic epidural insertion in the Thiel soft embalmed cadaver: proof of concept simulation study.
Br J Anaesth
January 2025
Optomize Ltd, Glasgow, UK.
Advances in Anesthesia Techniques for Postoperative Pain Management in Minimally Invasive Cardiac Surgery: An Expert Opinion.
J Cardiothorac Vasc Anesth
January 2025
Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. Electronic address:
Minimally invasive cardiac surgery (MICS) often leads to severe postoperative pain. At present, multimodal analgesia schemes for MICS have attracted much attention, and the application of various chest wall analgesia techniques is becoming increasingly widespread. However, research on anesthesia techniques for postoperative pain management in MICS remains relatively limited at present.
View Article and Find Full Text PDFThoracic Epidural and Intercostal Nerve Cryoablation in Multimodal Analgesia for Acute Pain Management of Rib Fractures: A Case Report.
Cureus
December 2024
Anesthesiology, Rhode Island Hospital, Brown University, Providence, USA.
Acute pain service was consulted for acute pain management in a 40-year-old male who had sustained multiple bilateral rib fractures following a fall injury. In addition to the rib fractures, the patient had also experienced injuries to his lungs and spinal column, both of which required surgeries. Considering the significant nature of pain due to his rib fractures, a multimodal pain management approach that included both pharmacological and non-pharmacological strategies was utilized.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!