1Ali Raza, 2Shahid Adalat Chaudhry, 3Ahmed khan, 4Dr. Syed Imtiaz Ali Zaidi, 5Kashif Lodhi, 6Dr. Abaid ur Rehman
1PIMS
2Mohi-ud-Din Islamic Medical College, Mirpur AJ & K
3Assistant Professor, Suleman Roshan Medical College Hospital Tando Adam Pakistan
4Assistant Professor, Department of Anaesthesiology & Intensive Care, Avicenna Medical College & Hospital, Lahore, Pakistan
5Department of Agricultural, Food and Environmental Sciences. Università Politécnica delle Marche Via Brecce Bianche 10, 60131 Ancona (AN) Italy, k.lodhi@studenti.unibg.it
6Associate Professor, Anesthesia, Rashid Latif Medical College/ Hameed Latif hospital Lahore
ABSTRACT:
OBJECTIVE: This study aimed to examine the effects on intraoperative hemodynamics, fluid requirements, and postoperative patient outcomes. The study used a comparative approach to assess the relative advantages and disadvantages of the two types of anesthesia.
METHODS: Data analysis was carried on those patients undergone open hepatectomy at Mayo Hospital between December 2019 and January 2023. Depending on the kind of intraoperative anesthesia they got, the research split these patients into two groups: those who received epidural local anesthetic (either as a bolus or continuously) and those who did not. Laparoscopic or non-elective surgery patients were not included in the research.
RESULTS: 103 individuals were analyzed, of which 14 were controls and 89 had epidural anesthesia. Across groups, there were no notable demographic differences. In comparison to control patients, epidural patients did not need more intraoperative intravenous fluid delivery, blood loss, or vasopressor usage. Individuals who had epidurals needed fewer intravenous opioids and had lower post-operative pain ratings both immediately after surgery and on day two. No group differed from the others in terms of the time it took to ambulate or the severity of post-operative acute renal damage.
CONCLUSIONS: This study demonstrates that patients having hepatectomy procedures under combined general and epidural anesthesia: 1) do not require more intraoperative crystalloid; 2) require less total intravenous opioid dose; and 3) report feeling less pain afterward. Hence, for oncological treatments based on the ERAS protocol, intraoperative epidural anesthesia in combination with general anesthesia may be beneficial.
KEYWORDS: hepatectomy, anesthesia, analgesia