Stručni rad

Thoracic Epidural Analgesia for Radical Cystectomy Improves Bowel Function Even in Traditional Perioperative Care: A Retrospective Study in Eighty-Five Patients

Branka Mazul-Sunko ; Departmetnt of Anesthesiology and Intensive Care, Sveti Duh University Hospital,Zagreb, Croatia
Ivan Gilja ; Department of Urology, Sveti Duh University Hospital,Zagreb, Croatia
Milana Jelisavac ; Departmetnt of Anesthesiology and Intensive Care, Sveti Duh University Hospital,Zagreb, Croatia
Iva Kožul ; Department of Urology, Sveti Duh University Hospital,Zagreb, Croatia
Damir Troha ; Vinkovci General Hospital, Vinkovci, Croatia
Nedžad Osmančević ; Departmetnt of Anesthesiology and Intensive Care, Sveti Duh University Hospital,Zagreb, Croatia
Ahmad El-Saleh ; Department of Urology, Sveti Duh University Hospital,Zagreb, Croatia
Ana Markić ; Departmetnt of Anesthesiology and Intensive Care, Sveti Duh University Hospital,Zagreb, Croatia
Marko Kovačević ; Departmetnt of Anesthesiology and Intensive Care, Sveti Duh University Hospital,Zagreb, Croatia
Petar Bokarica ; Department of Urology, Sveti Duh University Hospital,Zagreb, Croatia

Sažetak

Radical cystectomy is associated with significant morbidity and mortality due to complex surgery and comorbidities associated with advanced age of patients. In contrast to the surgery, which is clearly the procedure of choice for patients with invasive bladder cancer, the optimal anesthesiologic method is still under debate. Therefore, we retrospectively analyzed 85 patients having undergone radical cystectomy at our institution, either under combined epidural-general anesthesia (CEG A) or opioid based general anesthesia (GA). The intraoperative blood loss was significantly lower in CEG A group (497.37±354.13) than in GA group (742.31±403.69; p=0.006), due to induced hypotension. Consequently, blood transfusion requirements were lower in CEG A group (107.20±263.92) than in GA group (388.18±321.32; p=0.001). The incidence of postoperative ileus was also lower in CEG A group (p=0.024). There was no difference in analgesic efficacy, but a trend towards lower incidence of venous thrombosis and infection was noticed. The results of our study suggest that epidural anesthesia might have specific advantages in patients undergoing radical cystectomy.

Ključne riječi

Cystectomy; Anesthesia, epidural; Anesthesia, general

Hrčak ID:

133241

URI

https://hrcak.srce.hr/133241

Datum izdavanja:

3.11.2014.

Podaci na drugim jezicima: hrvatski

Posjeta: 3.489 *