ORIGINAL ARTICLES   

Giornale Italiano di Chirurgia Vascolare 2000 December;7(4):303-8

Copyright © 2001 EDIZIONI MINERVA MEDICA

language: English, Italian

Thoracic epidural anaesthesia and abdominal aortic surgery. A preliminary clinical study

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.