Postoperative pain relief using thoracic epidural analgesia: outstanding success and disappointing failures
Six hundred and forty patients received epidural analgesia for postoperative pain relief following major surgery in the 6‐year period 1993–1998. Although satisfactory pain relief was achieved in over two‐thirds of patients for a median duration of 44 h after surgery, one‐fifth of patients (133 indiv...
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| Veröffentlicht in: | Anaesthesia 2001-01, Vol.56 (1), p.75-81 |
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| creator | McLeod, G. A. Davies, H. T. O. Munnoch, N. Bannister, J. Macrae, W. |
| description | Six hundred and forty patients received epidural analgesia for postoperative pain relief following major surgery in the 6‐year period 1993–1998. Although satisfactory pain relief was achieved in over two‐thirds of patients for a median duration of 44 h after surgery, one‐fifth of patients (133 individuals) still experienced poor pain relief. Almost one out of three patients (194 individuals) had a problem with their epidural. Eighty‐three patients (13%) suffered a technical failure and 84 (13%) patients had their epidurals removed at night time when pain‐free because of pressure on beds. Seven patients had their epidural replaced and subsequently experienced excellent pain relief for a median of 77 h. Lack of resources prevented a further 480 patients from receiving the potential benefits of epidural analgesia. These results would suggest that the practical problems of delivering an epidural service far outweigh any differences in drug regimens or modes of delivery of epidural solutions. |
| doi_str_mv | 10.1046/j.1365-2044.2001.01763-7.x |
| format | Article |
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A.</creatorcontrib><creatorcontrib>Davies, H. T. O.</creatorcontrib><creatorcontrib>Munnoch, N.</creatorcontrib><creatorcontrib>Bannister, J.</creatorcontrib><creatorcontrib>Macrae, W.</creatorcontrib><title>Postoperative pain relief using thoracic epidural analgesia: outstanding success and disappointing failures</title><title>Anaesthesia</title><addtitle>Anaesthesia</addtitle><description>Six hundred and forty patients received epidural analgesia for postoperative pain relief following major surgery in the 6‐year period 1993–1998. Although satisfactory pain relief was achieved in over two‐thirds of patients for a median duration of 44 h after surgery, one‐fifth of patients (133 individuals) still experienced poor pain relief. Almost one out of three patients (194 individuals) had a problem with their epidural. Eighty‐three patients (13%) suffered a technical failure and 84 (13%) patients had their epidurals removed at night time when pain‐free because of pressure on beds. Seven patients had their epidural replaced and subsequently experienced excellent pain relief for a median of 77 h. Lack of resources prevented a further 480 patients from receiving the potential benefits of epidural analgesia. These results would suggest that the practical problems of delivering an epidural service far outweigh any differences in drug regimens or modes of delivery of epidural solutions.</description><subject>Aged</subject><subject>Anaesthesia</subject><subject>Analgesia, Epidural - methods</subject><subject>Anesthesia</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Critical Care - organization & administration</subject><subject>epidural</subject><subject>Equipment Failure</subject><subject>Humans</subject><subject>Local anesthesia. Pain (treatment)</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pain</subject><subject>Pain Measurement</subject><subject>Pain, Postoperative - drug therapy</subject><subject>postoperative</subject><subject>regional</subject><subject>Treatment Failure</subject><subject>Treatment Outcome</subject><issn>0003-2409</issn><issn>1365-2044</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqVkEtv1DAURi0EokPhL6AIJHYJfsWP7qZVeUgVsIC15XGuiwdPEnwTaP89CTMqa1ZXV9-5Dx1CXjHaMCrV233DhGprTqVsOKWsoUwrUevm7hHZPESPyYZSKmouqT0jzxD3C8oNM0_JGWNMaSnZhvz4MuA0jFD8lH5BNfrUVwVygljNmPrbavo-FB9SqGBM3Vx8rnzv8y1g8hfVME84-b5bQZxDAMQl7qouoR_HIfXTmkSf8lwAn5Mn0WeEF6d6Tr69u_569aG--fz-49X2pg6ylboGkEpGCZZbZk3csdYqBVbxsARCSKGZCa3l4KNsIwRlAzXKcN3SEIPYiXPy5rh3LMPPGXByh4QBcvY9DDM6TVtjKDULeHEEQxkQC0Q3lnTw5d4x6lbVbu9Wn2716VbV7q9qp93dMvzydGXeHaD7N3pyuwCvT4DH4HMsvg8JHzijLG_1Ql0eqd8pw_1_POC2n7bXx0b8AV76nNI</recordid><startdate>200101</startdate><enddate>200101</enddate><creator>McLeod, G. 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Pain (treatment)</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pain</topic><topic>Pain Measurement</topic><topic>Pain, Postoperative - drug therapy</topic><topic>postoperative</topic><topic>regional</topic><topic>Treatment Failure</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>McLeod, G. A.</creatorcontrib><creatorcontrib>Davies, H. T. O.</creatorcontrib><creatorcontrib>Munnoch, N.</creatorcontrib><creatorcontrib>Bannister, J.</creatorcontrib><creatorcontrib>Macrae, W.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Anaesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>McLeod, G. A.</au><au>Davies, H. T. O.</au><au>Munnoch, N.</au><au>Bannister, J.</au><au>Macrae, W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Postoperative pain relief using thoracic epidural analgesia: outstanding success and disappointing failures</atitle><jtitle>Anaesthesia</jtitle><addtitle>Anaesthesia</addtitle><date>2001-01</date><risdate>2001</risdate><volume>56</volume><issue>1</issue><spage>75</spage><epage>81</epage><pages>75-81</pages><issn>0003-2409</issn><eissn>1365-2044</eissn><coden>ANASAB</coden><abstract>Six hundred and forty patients received epidural analgesia for postoperative pain relief following major surgery in the 6‐year period 1993–1998. Although satisfactory pain relief was achieved in over two‐thirds of patients for a median duration of 44 h after surgery, one‐fifth of patients (133 individuals) still experienced poor pain relief. Almost one out of three patients (194 individuals) had a problem with their epidural. Eighty‐three patients (13%) suffered a technical failure and 84 (13%) patients had their epidurals removed at night time when pain‐free because of pressure on beds. Seven patients had their epidural replaced and subsequently experienced excellent pain relief for a median of 77 h. Lack of resources prevented a further 480 patients from receiving the potential benefits of epidural analgesia. These results would suggest that the practical problems of delivering an epidural service far outweigh any differences in drug regimens or modes of delivery of epidural solutions.</abstract><cop>Oxford, UK</cop><pub>Blackwell Science Ltd</pub><pmid>11167441</pmid><doi>10.1046/j.1365-2044.2001.01763-7.x</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Anaesthesia Analgesia, Epidural - methods Anesthesia Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Critical Care - organization & administration epidural Equipment Failure Humans Local anesthesia. Pain (treatment) Medical sciences Middle Aged Pain Pain Measurement Pain, Postoperative - drug therapy postoperative regional Treatment Failure Treatment Outcome |
| title | Postoperative pain relief using thoracic epidural analgesia: outstanding success and disappointing failures |
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