• Der Urologe. Ausg. A · Jan 2000

    [Prolonged peridural analgesia (PDA) for postoperative pain therapy after major urologic interventions. Experiences with 172 adult patients].

    • M Fügen, J Eberle, R Gerber, H Högström, and U E Studer.
    • Urologische Universitätsklinik.
    • Urologe A. 2000 Jan 1; 39 (1): 41-7.

    UnlabelledThe benefits of epidural analgesia are well known, but it is not well understood which types of urologic surgery benefit most from epidural analgesia. In this study, the effects and side effects of prolonged epidural analgesia are prospectively examined and analysed on 172 adult patients in three different operation groups. An epidural infusion of local anaesthetic combined with an opioid and adrenaline was given for a period of 5-7 days. There was no difference between the groups with respect to the effectiveness of the analgesia and patients' perception of the treatment. Mobilization differed, as expected, between the groups, however even after the most major surgery (e. g. cystectomy with bladder substitution), mobilization was impressively unproblematic. Retarded return of regular intestinal function after the transperitoneal operation and partly after lumbotomy compared with the extraperitoneal operation depended on which operation was performed and the amount of analgesia given. The side effects such as sedation, nausea and pruritus were conditional partly on the opiate and partly on the intervention. Up to 11 % showed slight muscular weakness of the lower limbs as a specific side effect of the local anaesthetic.ComplicationsOne patient died of cerebral hypoxia due to an initially undetected subdural catheter placement complicated by severe pre-existent carotid stenosis. In four patients, the epidural analgesia had to be stopped because of catheter migration. There was no clinical evidence of hematoma, abscess or permanent neurological damage. Epidural analgesia works well in terms of analgesia, mobilization and patient satisfaction, bearing in mind the potential side effects and complications. It can be recommended for lumbotomy and long transperitoneal operations however not for extraperitoneal interventions in the lower abdomen such as radical prostatectomy.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…