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Open Access 01-12-2019 | Pancreatectomy | Original Article

Epidural and Non-epidural Analgesia in Patients Undergoing Open Pancreatectomy: a Retrospective Cohort Study

Authors: Jesse V. Groen, David E. F. Slotboom, Jaap Vuyk, Chris H. Martini, Albert Dahan, Alexander L. Vahrmeijer, Bert A. Bonsing, J. Sven D. Mieog

Published in: Journal of Gastrointestinal Surgery | Issue 12/2019

Abstract

Background

The use of epidural analgesia (EA) in pancreatic surgery remains under debate. This study compares patients treated with EA versus non-EA after open pancreatectomy in a tertiary referral center.

Methods

All patients undergoing open pancreatectomy from 2013 to 2017 were retrospectively reviewed. (Non-)EA was terminated on postoperative day (POD) 3 or earlier if required.

Results

In total, 190 (72.5%) patients received EA and 72 (27.5%) patients received non-EA (mostly intravenous morphine). EA was terminated prematurely in 32.6% of patients and non-EA in 10.5% of patients. Compared with non-EA patients, EA patients had significantly lower pain scores on POD 0 (1.10 (0–3.00) versus 3.00 (1.67–5.00), P < 0.001) and POD 1 (2.00 (0.50–3.41) versus 3.00 (2.00–3.80), P = 0.001), though significantly higher pain scores on POD 3 (3.00 (2.00–4.00) versus 2.33 (1.50–4.00), P < 0.001) and POD 4 (2.50 (1.50–3.67) versus 2.00 (0.50–3.00), P = 0.007). EA patients required more vasoactive medication perioperatively and had higher cumulative fluid balances on POD 1–3. Postoperative complications were similar between groups.

Conclusions

In our cohort, patients with EA experienced significantly lower pain scores in the first PODs compared with non-EA, yet higher pain scores after EA had been terminated. Although EA patients required more vasoactive medication and fluid therapy, the complication rate was similar.

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Title: Epidural and Non-epidural Analgesia in Patients Undergoing Open Pancreatectomy: a Retrospective Cohort Study
Authors: Jesse V. Groen
David E. F. Slotboom
Jaap Vuyk
Chris H. Martini
Albert Dahan
Alexander L. Vahrmeijer
Bert A. Bonsing
J. Sven D. Mieog
Publication date: 01-12-2019
Publisher: Springer US
Keywords: Pancreatectomy
Opioids
Opioids
Analgesics in Dentistry
Morphine
Published in: Journal of Gastrointestinal Surgery / Issue 12/2019
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-019-04136-w

ACC 2024 Congress

Springer Medicine

Epidural and Non-epidural Analgesia in Patients Undergoing Open Pancreatectomy: a Retrospective Cohort Study

Abstract

Background

Methods

Results

Conclusions

ACC 2024 Congress

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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