Maharjan S K, Shrestha B M
Department of Anaesthesiology, Kathmandu Medical College, Sinamangal, KTM.
Kathmandu Univ Med J (KUMJ). 2004 Jan-Mar;2(1):18-23.
Among various methods of providing analgesia during surgery for e.g., parenteral opiates and NSAIDS, epidural anaesthesia and analgesia seem to have beneficial efficacy and less side effect profiles.
This study was conducted in 1.53 patients coming for operation at KMCTH between August 2003 to August 2004. Patients were divided in two groups, one group were operated under sole epidural anaesthesia and the other group received a combination of either general anaesthesia or spinal anaesthesia.
39 (25.5%) patients underwent sole lumbar epidurals, 36 (23.5%) patients received a combination with spinal (CSE) and 78 (51.0%) were under Combination with general anaesthesia. The patients were interviewed among whom it was found that satisfactory analgesia was reported by 75 cases and 73 cases reported excellent analgesia. Patchy anaesthesia observed in 5 cases who underwent sole epidural anaesthesia.
DISCUSSION & CONCLUSION: Patients undergoing major surgery with epidural anaesthesia and analgesia had stable cardiovascular parameters, minimal neuroendocrine response, less respiratory complications including SIRS and sepsis, lower incidence of thromboembolic events, less blood loss, reduced hospital stay and better pain control.
