ArticleBritish journal of pain2015
Epidural analgesia provides effective pain relief in patients undergoing open liver surgery.
Article in British journal of pain, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 32 citations in OpenAlex.
- Comparison of the effects of patient-controlled epidural and intravenous analgesia on postoperative bowel function after laparoscopic gastrectomy: a prospective randomized study.Surgical endoscopy · 2017Trial
- Trial
- The effectiveness and outcomes of epidural analgesia in patients undergoing open liver resection: a propensity score matching analysis.BMC anesthesiology · 2024Observational
- Effect of thoracic epidural anesthesia on postoperative outcome in major liver surgery: a retrospective cohort study.Langenbeck's archives of surgery · 2023Article
- Long-term effect of anesthesia choice on patients with hepatocellular carcinoma undergoing open liver resection.Frontiers in oncology · 2022Review
- Postoperative Analgesia after Open Liver Surgery: Systematic Review of Clinical Evidence.Journal of clinical medicine · 2021Review
- Subpleural multilevel intercostal continuous analgesia after thoracoscopic pulmonary resection: a pilot study.Journal of cardiothoracic surgery · 2019Observational
- Enhanced recovery after surgery in liver resection: current concepts and controversies.Korean journal of anesthesiology · 2019Review
- Epidural dexmedetomidine infusion for perioperative analgesia in patients undergoing abdominal cancer surgery: randomized trial.Journal of pain research · 2018Article
- Article
- Role of epidural anesthesia in a fast track liver resection protocol for cirrhotic patients - results after three years of practice.World journal of hepatology · 2016Article
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Authors and funding
6 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundEpidural analgesia has been the reference standard for the provision of post-operative pain relief in patients recovering from major upper abdominal operations, including liver resections. However, a failure rate of 20-32% has been reported.
aimThe aim of the study was to analyse the success rates of epidural analgesia and the outcome in patients who underwent liver surgery.
methodsWe collected data from a prospectively maintained database of 70 patients who underwent open liver surgery by a bilateral subcostal incision during a period of 20 months (February 2009 to September 2010). Anaesthetic consultants with expertise in anaesthesia for liver surgery performed the epidural catheter placement. A dedicated pain team assessed the post-operative pain scores on moving or coughing using the Verbal Descriptor Scale. The outcome was measured in terms of epidural success rates, pain scores, post-operative chest infection and length of hospital stay.
resultsThe study group included 43 males and 27 females. The indication for resection was liver secondaries (70%), primary tumours (19%) and benign disease (11%). While major (≥3 segments) and minor resections (≤ 2 segments) were performed in 44% and 47% respectively, 9% of patients were inoperable. Epidural analgesia was successful in 64 patients (91%). Bacterial colonisation of epidural tip was noticed in two patients. However, no neurological complications were encountered. Five patients (7%) had radiologically confirmed chest infection. Four patients (6%) developed wound infection. One patient died due to liver failure following extended right hepatectomy and cholecystectomy for gall bladder cancer. The median length of stay was 6 days (3-27 days). The extent of liver resection (p = 0.026) and post-operative chest infection (p = 0.012) had a significant influence on the length of stay.
conclusionOur experience shows that epidural analgesia is safe and effective in providing adequate pain relief following open liver surgery.
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