Comparison of pain management after laparoscopic distal gastrectomy with and without epidural analgesia

Surg Today. 2016 Feb;46(2):229-34. doi: 10.1007/s00595-015-1162-y. Epub 2015 Apr 11.

Abstract

Purpose: The optimal analgesia following laparoscopic distal gastrectomy (LDG) has not been determined; moreover, it has been unclear whether epidural anesthesia has benefits for laparoscopic surgery. In this study, we evaluated the effectiveness of epidural analgesia after LDG.

Methods: This retrospective study included 84 patients who underwent LDG for gastric cancer. Patients received either combined thoracic epidural and general anesthesia (Epidural group, n = 34) or general anesthesia alone (No epidural group, n = 50). We recorded data on the patients, surgery, postoperative outcomes and anesthesia-related complications.

Results: In the Epidural group, the first day of flatus was significantly earlier (2.21 vs. 2.44 days, p = 0.045) and the number of additional doses of analgesics was significantly lower (2.85 vs. 4.86 doses, p = 0.007) than in the No epidural group. Postoperative urinary retention occurred at a significantly higher rate in the Epidural group (n = 7; 20.6 %) than in the No epidural group (p < 0.001).

Conclusion: Epidural anesthesia may reduce the need for additional analgesics after LDG, but increases the risk of urinary retention.

Keywords: Epidural anesthesia; Laparoscopic distal gastrectomy; Urinary retention.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Analgesics / administration & dosage
  • Anesthesia, Epidural* / adverse effects
  • Anesthesia, General
  • Female
  • Fentanyl / administration & dosage
  • Gastrectomy*
  • Humans
  • Infusions, Intravenous
  • Laparoscopy*
  • Male
  • Middle Aged
  • Pain Management / methods*
  • Postoperative Care*
  • Retrospective Studies
  • Risk
  • Stomach Neoplasms / surgery*
  • Urinary Retention / etiology

Substances

  • Analgesics
  • Fentanyl