Einfluss der thorakalen Epiduralanalgesie auf die frühe postoperative Phase nach Eingriffen am Gastrointestinaltrakt

Zügel, Nikolaus; Bruer, C.; Breitschaft, K.; Angster, Robert

doi:10.1007/s00104-001-0398-9

Cited by 32 publications

(6 citation statements)

References 30 publications

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“…In a study of a similar postoperative regimen with epidural local anesthetics, forced mobilization and early oral feeding, a signifi cantly reduced feeling of fatigue was found in patients with TEA and there was no diff erence in the incidence of most side eff ects between EA and IV-PCA 6,10,17,18 . A large patient sample in the study performed by Flisberg et al 33 showed that patients with EA had better analgesia after major surgery with a reduced incidence of respiratory depression and sedation compared with patients with iv morphine analgesia.…”

Section: Discussionmentioning

confidence: 99%

Thoracic Epidural Versus Intravenous Patient-Controlled Analgesia after Open Colorectal Cancer Surgery

Radovanović

Skoric-Jokic³

et al. 2017

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SUMMARY -Th e aim of the study was to compare thoracic epidural analgesia (TEA) and intravenous patient-controlled analgesia (IV-PCA) after open colorectal cancer surgery. Th is prospective study included sixty patients scheduled for elective open colorectal surgery and randomized to either postoperative IV-PCA with morphine (n=30) or TEA with a mixture of levobupivacaine, fentanyl and adrenaline (n=30). Th e primary outcome was return of bowel function. Th e secondary outcome was quality of postoperative analgesia at rest, on coughing and during mobilization. Intermediate outcomes included patient satisfaction, time out of bed, rate of side eff ects and postoperative complications, and time of discharge. Recovery of postoperative ileus occurred sooner (p<0.001) and resumption of dietary intake was achieved earlier (p<0.001) in TEA group. Intensity of pain during the first 3 postoperative days was significantly lower at rest, on coughing and during mobilization (p<0.001), and mobilization was much more effi cient (p<0.005) in TEA than in IV-PCA group. Satisfaction scores were better in TEA group (p<0.001). Nausea, sedation and postoperative delirium occurred less frequently in TEA group (p<0.05, p<0.001 and p<0.05, respectively). TEA demonstrated significantly better eff ectiveness than IV-PCA after open colorectal cancer surgery and had a positive impact on bowel function, dietary intake, patient satisfaction and early mobilization. Th e results of this study demonstrated the importance of implementation of TEA as a preferred method for postoperative pain control after major open colorectal surgery.

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Section: Discussionmentioning

confidence: 99%

Thoracic Epidural Versus Intravenous Patient-Controlled Analgesia after Open Colorectal Cancer Surgery

Radovanović

Skoric-Jokic³

et al. 2017

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“…On the pathogenic basis, different risk factors have been analyzed such as surgical technique, stoma construction, length of operation, respiratory morbidity, the use of opioids as postoperative analgesia, and epidural administration [9,[13][14][15].…”

Section: Discussionmentioning

confidence: 99%

A Double‐Blinded Randomized Clinical Study on the Therapeutic Effect of Gastrografin^® in Prolonged Postoperative Ileus After Elective Colorectal Surgery

et al. 2015

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“…Zügel et al [62] wiesen darüber hinaus eine signifikant geringere 7 Anastomoseninsuffizienz nach gastrointestinalen Eingriffen nach, wenn eine thorakale Epiduralanalgesie in der postoperativen Phase eingesetzt wurde. Ebenfalls belegt ist die bessere Qualität der Schmerzunterdrückung mittels epiduraler Verfahren [12,59].…”

Section: Pcea Vs Pcia Bei Fast-track-protokollenunclassified

Fast-track rehabilitation in colon surgery

et al. 2007

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Fast-track rehabilitation refers to an interdisciplinary multimodal procedure to improve and accelerate recovery and avoid perioperative complications. The concept aims at reducing morbidity and discharging patients faster. It includes preoperative patient information, atraumatic surgical technique, stress reduction, pain therapy mostly via regional anesthetic techniques (frequently, thoracic epidural anesthesia), optimized fluid and temperature management, early enteral feeding, prophylaxis of gastrointestinal atony and postoperative nausea and vomiting, fast postoperative patient mobilization, and earlier hospital discharge. Fast-track protocols exist for all kind of surgical procedures but are best established for colon surgery.

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Einfluss der thorakalen Epiduralanalgesie auf die frühe postoperative Phase nach Eingriffen am Gastrointestinaltrakt

Abstract: The combination of TEA and general anesthesia has been shown to offer advantages after operations on both the upper and the lower GI tract. The positive effects of the TEA in the postoperative period should be used for the early enteric nutrition and mobilization of patients.

Cited by 32 publications

References 30 publications

Thoracic Epidural Versus Intravenous Patient-Controlled Analgesia after Open Colorectal Cancer Surgery

Thoracic Epidural Versus Intravenous Patient-Controlled Analgesia after Open Colorectal Cancer Surgery

A Double‐Blinded Randomized Clinical Study on the Therapeutic Effect of Gastrografin^® in Prolonged Postoperative Ileus After Elective Colorectal Surgery

Fast-track rehabilitation in colon surgery

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Einfluss der thorakalen Epiduralanalgesie auf die frühe postoperative Phase nach Eingriffen am Gastrointestinaltrakt

Abstract: The combination of TEA and general anesthesia has been shown to offer advantages after operations on both the upper and the lower GI tract. The positive effects of the TEA in the postoperative period should be used for the early enteric nutrition and mobilization of patients.

Cited by 32 publications

References 30 publications

Thoracic Epidural Versus Intravenous Patient-Controlled Analgesia after Open Colorectal Cancer Surgery

Thoracic Epidural Versus Intravenous Patient-Controlled Analgesia after Open Colorectal Cancer Surgery

A Double‐Blinded Randomized Clinical Study on the Therapeutic Effect of Gastrografin® in Prolonged Postoperative Ileus After Elective Colorectal Surgery

Fast-track rehabilitation in colon surgery

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Product

Resources

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A Double‐Blinded Randomized Clinical Study on the Therapeutic Effect of Gastrografin^® in Prolonged Postoperative Ileus After Elective Colorectal Surgery