Objective: The objective of this study was to evaluate the effects of intraoperative epidural anesthesia combined with balanced general anesthesia on intraoperative hemodynamics and fluid requirement, and on postoperative patient outcome.
Design: The study design was a retrospective data analysis of patients undergoing open hepatectomy at a single tertiary care center from May, 2013 to June, 2016. Patients undergoing hepatectomies were separated into two groups: patients not receiving epidural local anesthetic intraoperatively (either no epidural or epidural catheter not used intraoperatively) were designated the control group and patients receiving epidural local anesthetic intraoperatively (bolus and/or continuously). Patients were excluded if they underwent laparoscopic or non-elective procedures.
Results: 103 patients were included in the data analysis: Control n=14, Epidural = 89 patients. There were no major differences in demographics between groups. Epidural patients did not have higher requirements in intraoperative intravenous fluid administration, blood loss, or vasopressor use compared to control patients. Patients who received epidurals required less intravenous opioids with better post-operative pain scores initially and also on post-operative day 2. There were no differences in length of time to ambulation, or post-operative acute kidney injury amongst groups.
Conclusions: This study shows that patients undergoing hepatectomies using combined epidural and general anesthesia: 1) have no increased requirement for intraoperative crystalloid, colloid, or blood component therapy, 2) require lower total intravenous opioid dose, and 3) subjectively report better pain control. Therefore, intraoperative epidural anesthesia combined with general anesthesia may be advantageous for ERAS protocol based oncological procedures.
I want to thank you for our collaboration. You were fast and effective with a positive spirit of teamwork.
I am truly excited from our collaboration. You were like always fast, efficient and accurate.
I hope that in the near future we will collaborate again.
Many thanks for publishing my article in your great journal and the friendly and hassle-free publication process, the constructive peer-review, the regular feedback system, and the Quick response to any queries.
Azab Elsayed Azab
I wanna to thank Clinical Journal of Nursing Care and Practice for its effort to review and publish my manuscript. This is reputable journal. Thank you!
Really good service with prompt response. Looking forward to having long lasting relationship with your journal
The service from the journal staff has been excellent.
"It was a pleasure to work with the editorial team of the journal on the submission of the manuscript. The team was professional, fast, and to the point".
NC A&T State University, USA
The submission is very easy and the time from submission to response from the reviewers is short. Correspondence with the journal is nice and rapid.
Congratulations for the excellence of your journal and high quality of its publications.
Angel MARTIN CASTELLANOS
I wanna to thank clinical journal of nursing care and practice for its effort to review and publish my manuscript. This is reputable journal. Thank you!
Wollo University, Ethiopia
"This is my first time publishing with the journal/publisher. I am impressed at the promptness of the publishing staff and the professionalism displayed. Thank you for encouraging young researchers like me!"