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Online ISSN 1827-1847
Melchiorri C., Minicucci S., Comis M., Reviglio P., Coglitore R., Udini M. *, Gaggiano A. *, Palombo D. *, Lupo M.
From the Cardiovascular Anaesthesia and Resuscitation Unit * Vascular Surgery Unit Department of Cardiac and Vascular Diseases Mauriziano Umberto I Hospital, Turin, Italy
Background. The surgical stress of abdominal aortic procedures can lead to multiple organ failure in the postoperative period. The aim of the present study is to assess the use of intra- and postoperative thoracic epidural anaesthesia to control the response to surgical stress.
Methods. A retrospective clinical study was conducted on 80 patients given elective subrenal aortic grafts. The patients were divided into two groups: 47 given blended anaesthesia involving intra- and postoperative thoracic epidural analgesia (Group A) and 33 given blended general anaesthesia combined with postoperative opiate analgesia (Group B). Intra- and postoperative complications and mean postoperative hospital stay were then analysed.
Results. Fewer intraoperative complications were found in Group A including hypertension, delayed awakening and time in Intensive Care. Group A also revealed fewer cases of nausea, vomiting, pain and high blood pressure as well as faster recovery of gastroenteric function and shorter postoperative hospital stays than Group B.
Conclusions. It is therefore concluded that a multimodal, multidisciplinary approach involving intra- and postoperative thoracic epidural anaesthesia appears to improve outcome and reduce morbidity and hospital stay in patients subjected to abdominal aortic surgery.
language: English, Italian