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

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.