• Renatas Tikuisis, Saulius Cicenas, Aleksas Zurauskas, Povilas Miliauskas, and Eugenijus Stratilatovas.
• Institute of Oncology, Vilnius University, Santariskiu 1, 2600 Vilnius, Lithuania. rent@mail.lt
• Medicina (Kaunas). 2002 Jan 1;38 Suppl 2:75-8.

ObjectiveTo view combined anesthesia benefits versus general anesthesia and to compare postoperative epidural analgesia and patient-controlled analgesia with intravenous morphine.Material And MethodsTwenty four patients scheduled for elective thoracoabdominal esophagectomy were randomized to T (n=12) and K (n=12) groups. Group T patients received epidural analgesia with 0.125 percent bupivocaine and morphine after combined general-epidural anesthesia and group K patients received intravenous patient-controlled analgesia with morphine after general anesthesia. The patients were monitored for operation and extubation time, for postoperative pain and length of intensive care unite (ICU) stay.ResultsT group patients received 79 percents less narcotics than K group. At rest there were no differences in pain relief between the groups. Pain scores at mobilization showed a significantly lower value in the T group. Patients in T group were tracheally extubated earlier (mean 210 minutes vs 380 min.) after admission to the ICU and discharged from the ICU earlier (mean 2.3 vs 4.3 days).ConclusionsCombined anesthesia and epidural analgesia improve overall outcome, provide better postoperative pain relief, shorten the intubation time and intensive care stay in patients undergoing esophageal resection operations.

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