ZAK Zürich pp 360-363 | Cite as

Influence of Epidural Analgesia with Local Anesthetics and Morphine on Morbidity after Abdominal Surgery

  • H. Kehlet
  • N.-C. Hjortsø
Conference paper
Part of the Anaesthesiologie und Intensivmedizin / Anaesthesiology and Intensive Care Medicine book series (A+I, volume 188)

Abstract

During recent years, epidural techniques for postoperative pain treatment, using either local anesthetics or opiates or a combination of these agents, have become increasingly popular. Several studies have demonstrated that such techniques may provide excellent relief of pain and, concomitantly, it has been shown that a major part of the classic endocrine-metabolic responses to surgery may be mitigated [6]. However, aside from the alleviation of postoperative pain, it is still somewhat uncertain whether epidural analgesia may also influence the incidence of postoperative morbidity. During surgical procedures performed on the lower part of the body and the lower extremities, data acquired from controlled studies have demonstrated that epidural analgesia or spinal analgesia may reduce blood loss and the incidence of thromboembolic complications and mortality [7], but only scant information is available concerning major abdominal procedures.

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References

  1. 1.
    Bormann B von, Weidler B, Dennhardt R, Sturm G, Scheid HH, Hempelmann G (1983) Influence of epidural fentanyl on stress-induced elevation of plasma vasopressin (ADH) after surgery. Anesth Analg 62:727PubMedCrossRefGoogle Scholar
  2. 2.
    Hendolin H, Tuppurainen T, Lathinen J (1982) Throacic epidural analgesia and deep vein thrombosis in cholecystectomized patients. Acta Chir Scand 148:405PubMedGoogle Scholar
  3. 3.
    Hjortsø NC, Andersen T, Frøsig F, Neumann P, Rogon E, Kehlet H (1984) Failure of epidural analgesia to modify postoperative depression of delayed hypersensitivity. Acta Anaesthesiol Scand 28:120CrossRefGoogle Scholar
  4. 4.
    Hjortsø NC, Andersen T, Frøsig F, Lindhard A, Neumann P, Rogon E, Kehlet H (1985) Influence of epidural analgesia with local anaesthetics and morphine on morbidity after abdominal surgery. Acta Anaestehsiol Scand (to be published)Google Scholar
  5. 5.
    Hjortsø NC, Andersen T, Christensen NJ, Kehlet H (1985) Influence of pain alleviation by epidural analgesia with local anaesthetics and morphine on urinary excretion of Cortisol, catecholamines and nitrogen after abdominal surgery. Br J Anaesth (to be published)Google Scholar
  6. 6.
    Kehlet H (1982) The modifying effect of general and regional anesthesia on the endocrine-metabolic response to surgery. Reg Anesth 7:38Google Scholar
  7. 7.
    Kehlet H (1983) Influence of regional anaesthesia on postoperative morbidity. In: Meyer J, Nolte H (eds) Die kontinuierliche Periduralanaesthesie. Thieme, Stuttgart, p 75Google Scholar
  8. 8.
    Mellbring G, Dahlgren S, Reiz S, Sunnegardh O (1983) Thromboembolic complications after major abdominal surgery: Effect of thoracic epidural analgesia. Acta Chir Scand 149:263PubMedGoogle Scholar
  9. 9.
    Reiz S, Bâlfors E, Sørensen MB, Häggmark S, Nyhman H (1982) Coronary hemodynamic effects of general anesthesia and surgery. Reg Anesth 7:8Google Scholar
  10. 10.
    Rybro L, Schurizek BA, Petersen TK, Wernberg M (1982) Postoperative analgesia and lung function: A comparison of intramuscular with epidural morphine, Acta Anaesthesiol Scand 26:514PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1986

Authors and Affiliations

  • H. Kehlet
  • N.-C. Hjortsø

There are no affiliations available

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