Effect of epidural and general anaesthesia compared with general anaesthesia alone in large bowel anastomoses. A prospective study.

OBJECTIVE

To find out whether patients did better after operations that entailed a large bowel anastomosis if they were given combined epidural and general anaesthesia with spontaneous ventilation rather than standard general anaesthesia with muscle relaxation and ventilation.

DESIGN

Prospective randomised trial.

SETTING

Specialist unit, teaching hospital.

SUBJECTS

80 patients undergoing large bowel anastomoses.

MAIN OUTCOME MEASURES

Incidence of chest infection, wound infection, anastomotic breakdown, urinary tract infection, deep vein thrombosis, pulmonary embolism, median hospital stay and death.

RESULTS

There were no differences between the groups, but the results were better during the trial period (1985-89) than during the period 1978-83.

CONCLUSION

Factors that influence anastomotic healing are complex and improved surgical techniques, postoperative monitoring and patient care may account for the improvement in results compared with the earlier period.