Epidural anesthesia and analgesia in liver resection: Safety and effectiveness
Perioperative epidural analgesia in liver resection provides optimal dynamic pain relief. Coagulation disorders occurring in the postoperative period can lead to greater risk of complications during epidural catheter removal. The aim of this study is to evaluate the effectiveness and complications o...
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| Veröffentlicht in: | Revista española de anestesiología y reanimación 2017-02, Vol.64 (2), p.86-94 |
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| creator | Esteve, N Ferrer, A Sansaloni, C Mariscal, M Torres, M Mora, C |
| description | Perioperative epidural analgesia in liver resection provides optimal dynamic pain relief. Coagulation disorders occurring in the postoperative period can lead to greater risk of complications during epidural catheter removal. The aim of this study is to evaluate the effectiveness and complications of epidural analgesia and delayed epidural catheter removal due to postoperative coagulopathy.
A retrospective study of 114 patients undergoing open liver resection and epidural analgesia, from March 2012 to February 2015. Postoperative course of pain intensity, coagulation parameters and delayed catheter removal was analyzed RESULTS: Of the 114 operated patients, 73 met the inclusion criteria. 59% of patients received major hepatectomy (resection ≥ 3 segments) and 15% had Child's Class A cirrhosis (11/73). 96% of catheters functioned properly. 89% of patients had controlled pain (numerical rate scale 6) with movement. The INR peaked on postoperative day 2, 1.41 [0.99-2.30], and gradually returned to normal values in most patients by postoperative day 4, 1.26 [0.90 - 2.20]. The catheters were left in place 3.6 (± 1.1) days. In 6 patients (8%), catheter removal was postponed due to coagulation disorders.
Epidural analgesia for liver resection was a safe practice, which produced optimal control of postoperative pain. The percentage of delayed catheter removal due to postoperative coagulopathy was low, not requiring transfusion of blood products. |
| doi_str_mv | 10.1016/j.redar.2016.06.006 |
| format | Article |
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A retrospective study of 114 patients undergoing open liver resection and epidural analgesia, from March 2012 to February 2015. Postoperative course of pain intensity, coagulation parameters and delayed catheter removal was analyzed RESULTS: Of the 114 operated patients, 73 met the inclusion criteria. 59% of patients received major hepatectomy (resection ≥ 3 segments) and 15% had Child's Class A cirrhosis (11/73). 96% of catheters functioned properly. 89% of patients had controlled pain (numerical rate scale <3) at rest and 8.2% (6 patients) had severe pain (numerical rate scale > 6) with movement. The INR peaked on postoperative day 2, 1.41 [0.99-2.30], and gradually returned to normal values in most patients by postoperative day 4, 1.26 [0.90 - 2.20]. The catheters were left in place 3.6 (± 1.1) days. In 6 patients (8%), catheter removal was postponed due to coagulation disorders.
Epidural analgesia for liver resection was a safe practice, which produced optimal control of postoperative pain. The percentage of delayed catheter removal due to postoperative coagulopathy was low, not requiring transfusion of blood products.</description><identifier>EISSN: 2340-3284</identifier><identifier>DOI: 10.1016/j.redar.2016.06.006</identifier><identifier>PMID: 27554332</identifier><language>eng ; spa</language><publisher>Spain</publisher><subject>Adult ; Aged ; Analgesia, Epidural - adverse effects ; Analgesia, Epidural - instrumentation ; Anesthesia, Epidural - adverse effects ; Anesthesia, Epidural - instrumentation ; Blood Coagulation Disorders - etiology ; Blood Transfusion ; Catheters ; Device Removal ; Female ; Hepatectomy ; Humans ; International Normalized Ratio ; Male ; Middle Aged ; Pain Management - adverse effects ; Pain Management - methods ; Pain, Postoperative - prevention & control ; Postoperative Complications - etiology ; Retrospective Studies</subject><ispartof>Revista española de anestesiología y reanimación, 2017-02, Vol.64 (2), p.86-94</ispartof><rights>Copyright © 2016 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27554332$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Esteve, N</creatorcontrib><creatorcontrib>Ferrer, A</creatorcontrib><creatorcontrib>Sansaloni, C</creatorcontrib><creatorcontrib>Mariscal, M</creatorcontrib><creatorcontrib>Torres, M</creatorcontrib><creatorcontrib>Mora, C</creatorcontrib><title>Epidural anesthesia and analgesia in liver resection: Safety and effectiveness</title><title>Revista española de anestesiología y reanimación</title><addtitle>Rev Esp Anestesiol Reanim</addtitle><description>Perioperative epidural analgesia in liver resection provides optimal dynamic pain relief. Coagulation disorders occurring in the postoperative period can lead to greater risk of complications during epidural catheter removal. The aim of this study is to evaluate the effectiveness and complications of epidural analgesia and delayed epidural catheter removal due to postoperative coagulopathy.
A retrospective study of 114 patients undergoing open liver resection and epidural analgesia, from March 2012 to February 2015. Postoperative course of pain intensity, coagulation parameters and delayed catheter removal was analyzed RESULTS: Of the 114 operated patients, 73 met the inclusion criteria. 59% of patients received major hepatectomy (resection ≥ 3 segments) and 15% had Child's Class A cirrhosis (11/73). 96% of catheters functioned properly. 89% of patients had controlled pain (numerical rate scale <3) at rest and 8.2% (6 patients) had severe pain (numerical rate scale > 6) with movement. The INR peaked on postoperative day 2, 1.41 [0.99-2.30], and gradually returned to normal values in most patients by postoperative day 4, 1.26 [0.90 - 2.20]. The catheters were left in place 3.6 (± 1.1) days. In 6 patients (8%), catheter removal was postponed due to coagulation disorders.
Epidural analgesia for liver resection was a safe practice, which produced optimal control of postoperative pain. The percentage of delayed catheter removal due to postoperative coagulopathy was low, not requiring transfusion of blood products.</description><subject>Adult</subject><subject>Aged</subject><subject>Analgesia, Epidural - adverse effects</subject><subject>Analgesia, Epidural - instrumentation</subject><subject>Anesthesia, Epidural - adverse effects</subject><subject>Anesthesia, Epidural - instrumentation</subject><subject>Blood Coagulation Disorders - etiology</subject><subject>Blood Transfusion</subject><subject>Catheters</subject><subject>Device Removal</subject><subject>Female</subject><subject>Hepatectomy</subject><subject>Humans</subject><subject>International Normalized Ratio</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pain Management - adverse effects</subject><subject>Pain Management - methods</subject><subject>Pain, Postoperative - prevention & control</subject><subject>Postoperative Complications - etiology</subject><subject>Retrospective Studies</subject><issn>2340-3284</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo1UNtOwzAMjZAQm8a-AAn1kZeW3NwLb2gaF2mCB-C5ShsHMqVdSdpJ-3vCGJYt-1jnWLYJuWI0Y5Tlt9vMo1Y-4xFkNDrNz8icC0lTwUs5I8sQtjRaDpRLuCAzXgBIIficvKwHqyevXKJ6DOMXBqtiqWMo93lEtk-c3aNPPAZsR7vr75I3ZXA8HIlozG93j1EfLsm5US7g8pQX5ONh_b56Sjevj8-r-006cMbG1LS5BgO0RdGIPOfMSNAKpAakFae6EiDbsmoNK4wGUA1qUFSaRgGWshBiQW7-5g5-9z3FxevOhhadi1fsplCzEqqCSV5WkXp9ok5Nh7oevO2UP9T_PxA_xHNfBg</recordid><startdate>201702</startdate><enddate>201702</enddate><creator>Esteve, N</creator><creator>Ferrer, A</creator><creator>Sansaloni, C</creator><creator>Mariscal, M</creator><creator>Torres, M</creator><creator>Mora, C</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>201702</creationdate><title>Epidural anesthesia and analgesia in liver resection: Safety and effectiveness</title><author>Esteve, N ; Ferrer, A ; Sansaloni, C ; Mariscal, M ; Torres, M ; Mora, C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p211t-fc6d5f50ce3b36621f45da54d5e0920d9354c89cf17fd55abed5a04fba5e84733</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng ; spa</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Analgesia, Epidural - adverse effects</topic><topic>Analgesia, Epidural - instrumentation</topic><topic>Anesthesia, Epidural - adverse effects</topic><topic>Anesthesia, Epidural - instrumentation</topic><topic>Blood Coagulation Disorders - etiology</topic><topic>Blood Transfusion</topic><topic>Catheters</topic><topic>Device Removal</topic><topic>Female</topic><topic>Hepatectomy</topic><topic>Humans</topic><topic>International Normalized Ratio</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Pain Management - adverse effects</topic><topic>Pain Management - methods</topic><topic>Pain, Postoperative - prevention & control</topic><topic>Postoperative Complications - etiology</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Esteve, N</creatorcontrib><creatorcontrib>Ferrer, A</creatorcontrib><creatorcontrib>Sansaloni, C</creatorcontrib><creatorcontrib>Mariscal, M</creatorcontrib><creatorcontrib>Torres, M</creatorcontrib><creatorcontrib>Mora, C</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Revista española de anestesiología y reanimación</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Esteve, N</au><au>Ferrer, A</au><au>Sansaloni, C</au><au>Mariscal, M</au><au>Torres, M</au><au>Mora, C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Epidural anesthesia and analgesia in liver resection: Safety and effectiveness</atitle><jtitle>Revista española de anestesiología y reanimación</jtitle><addtitle>Rev Esp Anestesiol Reanim</addtitle><date>2017-02</date><risdate>2017</risdate><volume>64</volume><issue>2</issue><spage>86</spage><epage>94</epage><pages>86-94</pages><eissn>2340-3284</eissn><abstract>Perioperative epidural analgesia in liver resection provides optimal dynamic pain relief. Coagulation disorders occurring in the postoperative period can lead to greater risk of complications during epidural catheter removal. The aim of this study is to evaluate the effectiveness and complications of epidural analgesia and delayed epidural catheter removal due to postoperative coagulopathy.
A retrospective study of 114 patients undergoing open liver resection and epidural analgesia, from March 2012 to February 2015. Postoperative course of pain intensity, coagulation parameters and delayed catheter removal was analyzed RESULTS: Of the 114 operated patients, 73 met the inclusion criteria. 59% of patients received major hepatectomy (resection ≥ 3 segments) and 15% had Child's Class A cirrhosis (11/73). 96% of catheters functioned properly. 89% of patients had controlled pain (numerical rate scale <3) at rest and 8.2% (6 patients) had severe pain (numerical rate scale > 6) with movement. The INR peaked on postoperative day 2, 1.41 [0.99-2.30], and gradually returned to normal values in most patients by postoperative day 4, 1.26 [0.90 - 2.20]. The catheters were left in place 3.6 (± 1.1) days. In 6 patients (8%), catheter removal was postponed due to coagulation disorders.
Epidural analgesia for liver resection was a safe practice, which produced optimal control of postoperative pain. The percentage of delayed catheter removal due to postoperative coagulopathy was low, not requiring transfusion of blood products.</abstract><cop>Spain</cop><pmid>27554332</pmid><doi>10.1016/j.redar.2016.06.006</doi><tpages>9</tpages></addata></record> |
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| source | MEDLINE; Alma/SFX Local Collection |
| subjects | Adult Aged Analgesia, Epidural - adverse effects Analgesia, Epidural - instrumentation Anesthesia, Epidural - adverse effects Anesthesia, Epidural - instrumentation Blood Coagulation Disorders - etiology Blood Transfusion Catheters Device Removal Female Hepatectomy Humans International Normalized Ratio Male Middle Aged Pain Management - adverse effects Pain Management - methods Pain, Postoperative - prevention & control Postoperative Complications - etiology Retrospective Studies |
| title | Epidural anesthesia and analgesia in liver resection: Safety and effectiveness |
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