Post-Surgical Epidural May Boost Survival (HealthDay)
The use of epidural anesthetics for major surgery has been something controversial. There doesn't seem to be much question that it effectively reduces pain, but its safety has caused some concern.
"Using each epidural for pain check after a major operation was safe and actually caused a slightly improved survival for patients who received an epidural," said lead researcher Dr. Duminda Wijeysundera, from Ontario's Institute for Clinical Evaluative Sciences, department of anesthesia, at Toronto General Hospital and the University of Toronto.
canaille generally have less harass and a lower risk of pneumonia if they application an epidural after a major operation, Wijeysundera said. "But a lot of people are nervous about having an epidural, because it involves a needle and a catheter being placed in their back," he said.
This procedure allows medication to be delivered around the nerves in the epidural space of the spine to impede pain. Alternative methods of pain control include narcotic pain medication given by lavement or via an intravenous line.
The new report was published in the Aug. 11 online edition of The Lancet.
For the study, Wijeysundera's group collected data on more than 259,000 patients who underwent a major noncardiac surgery between 1994 and 2004.
Twenty-two percent of patients received an epidural anesthetic. The researchers found that these people were at a slightly lower risk of dying on the model of 30 days (1.7 percent) compared with patients who had not received an epidural (2.0 percent).
This means that to prevent one death, 477 patients would have to receive some epidural anesthetic, the researchers noted. In the United States, about unit million people a year go through a major proceeding, Wijeysundera declared.
"This study provides reassuring intelligence that epidural anesthetic is safe and may slightly increase the chance of surviving a major process," Wijeysundera said. "These results may help patients make better informed choices about how they manage their pain after a major operation," he said.
"You extremity to control post-operative pain," noted one expert, Dr. Zeev N. Kain, professorship of the station of Anesthesiology and Perioperative Care at the University of California, Irvine. "Pain is not good for you, because it hinders your recovery," he said.
The bottom line, Kain said, is that epidurals are safe and should be used but not because of this very slight improvement in survival. He believes that — especially with respect to major procedures — epidurals often relieve pain better than other methods.
"If you have surgeries to remove the pancreas or liver resection or a Whipple procedure, where they take moiety your abdominal cavity revealed, these are very painful procedures," Kain said. "For them, there is none question that the best pain relief is epidural," he said.
More information
For more on epidural anesthetic, visit the Medline Plus.