Incidence of epidural hematoma from use of epidural analgesia for hepatic resection surgery: A retrospective study

Su, Jackson; Soliz, José; Popat, Keyuri; Gebhardt, Rodolfo

doi:10.1016/j.jclinane.2020.109719

Cited by 4 publications

(2 citation statements)

References 5 publications

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“…Therefore, it is crucial to control these factors for postoperative pain relief. As a definitive standard analgesic modality, Epidural analgesia is losing favour due to increased risks of pruritis, retention, and hypotension 31 . However, the popularity of ultrasonography) has promoted regional analgesic techniques.…”

Section: Discussionmentioning

confidence: 99%

Relative efficacy and safety of several regional analgesic techniques following thoracic surgery: a network meta-analysis of randomized controlled trials

Li,

Sun,

Zong

et al. 2023

International Journal of Surgery

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Background: This network meta-analysis (NMA) was performed to assess the relative efficacy and safety of various regional analgesic techniques used in thoracic surgery. Materialsand methods: Randomized controlled trials (RCTs) evaluating different regional analgesic methods were retrieved from databases, including PubMed, Embase, Web of Science, and the Cochrane Library, from inception to March 2021. The surface under the cumulative ranking curve (SUCRA) was estimated to rank the therapies based on the Bayesian theorem. Moreover, sensitivity and subgroup analyses were performed on the primary outcomes to obtain more reliable conclusions. Results: Fifty-four trials (3,360 patients) containing six different methods were included. Thoracic paravertebral block (TPVB) and erector spinae plane block (ESPB) were ranked the highest in reducing postoperative pain. As for total adverse reactions and postoperative nausea and vomiting (PONV), postoperative complications, and duration of hospitalization, ESPB was found to be superior to other methods. It should be noted that there were few differences between various methods for all outcomes. Conclusions: Available evidence suggests that ESPB might be the most effective and safest method for relieving pain after thoracic surgery, shortening the length of hospital stay and reducing the incidence of postoperative complications.

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Section: Discussionmentioning

confidence: 99%

Relative efficacy and safety of several regional analgesic techniques following thoracic surgery: a network meta-analysis of randomized controlled trials

Li,

Sun,

Zong

et al. 2023

International Journal of Surgery

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“…Проте вона, крім позитивних результатів (потенціювання інтраопераційного знеболювання, можливість пролонгованої післяопераційної аналгезії, поліпшення результатів інтенсивної післяопераційної терапії -швидше відновлення перистальтики, можливість більш раннього початку ентерального харчування, зменшення ймовірності дихальної недостатності тощо), має ряд негативних (можливість гіпотензії, травмування судин епідурального простору тощо) [4]. Додатково, реалізувати ЕДА не завжди можливо, оскільки протипоказанням для її виконання є розлади гемостазу (що нерідко зустрічається у хворих із патологією печінки) з небезпекою виникнення підвищеної кровоточивості та формування епідуральної гематоми і непоправних неврологічних наслідків [7,9]. Наразі ведеться пошук Дослідження виконано відповідно до принципів Гельсінської декларації.…”

Section: оригінальні дослідження загальна хірургіяunclassified

Efficacy and safety of continuous intravenous lidocaine administration as a component of intraoperative analgesia and postoperative intensive care in extensive liver resections

Zatsarynnyi,

Biliaiev,

Tantsiura

et al. 2023

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Purpose - to improve the effectiveness and determine the safety of intraoperative analgesia and postoperative intensive care for extensive liver resections with intravenous lidocaine compared with traditional analgesia and the use of epidural anesthesia. Materials and methods. 108 patients of 18 years of age and older who underwent extensive liver resection were examined and analyzed. The studied patients were stratified into three groups, depending on the choice of intra- and postoperative analgesia: the Group I (22 patients) - intravenous lidocaine administration + traditional intra- and postoperative analgesia, the Group II (73 patients) - epidural anesthesia (EDA) in the thoracic spine + traditional intra - and postoperative analgesia, the Group III (13 patients) - control, which used only traditional intra- and postoperative analgesia. Probability of differences was assessed using Student’s t-test, non-parametric Mann-Whitney U-test, Pearson’s χ2 test. Results. The blood lidocaine concentration in 2 hours after surgery was higher in the Group II (2.37±1.08 μg/ml) compared to the Group I (1.84±1.16 μg/ml). The values for 14 hours after the intervention did not differ (2.62±2.56 μg/ml - in the Group I, 2.85±1.25 μg/ml - in the Group II). In some cases, the local anesthetic content exceeded the toxic level without corresponding clinical symptoms. Intravenous lidocaine administration led to a decrease pain intensity within 4 days after surgery by almost 1.5 times, epidural administration - by 1.5-2 times compared to the standard analgesia, and was also accompanied by a lengthening of the time interval until the first injection of narcotic analgesics from 86.968.2 min to 394.3666.5 and 553.252.8.5 min, respectively. Changing the route of local anesthetic administration from epidural to intravenous led to decrease intraoperative volume of infusion therapy from 9.4±2.5 ml/kg/h to 7.4±1.3 ml/kg/h, as well as to reduction of the norepinephrine dose to eliminate hypotension by 1.3 times. Lidocaine administration attenuated the intensity of the systemic inflammatory response syndrome, which was manifested by a reduction in the concentration of IL-1, IL-4, IL-10 compared to multicomponent analgesia without a statistical difference with the epidural route of lidocaine administration. Conclusions. The use of lidocaine as an adjuvant in traditional intra- and postoperative analgesia for extensive liver resection reduces pain intensity and the degree of systemic inflammatory response syndrome. Changing the method of using lidocaine from epidural to intravenous leads to more stable intraoperative blood circulation, reduction the volume of infusion therapy and the need for sympathomimetic support without increasing blood concentration, and in the proposed method is an attractive alternative to epidural analgesia. The research was carried out in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of the patients was obtained for the research. No conflict of interests was declared by the authors.

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Epidural Analgesia Is Associated with Prolonged Length of Stay After Open HPB Surgery in Over 27,000 Patients

Kone

Maker

Banulescu

et al. 2021

Journal of Gastrointestinal Surgery

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Incidence of epidural hematoma from use of epidural analgesia for hepatic resection surgery: A retrospective study

Cited by 4 publications

References 5 publications

Relative efficacy and safety of several regional analgesic techniques following thoracic surgery: a network meta-analysis of randomized controlled trials

Relative efficacy and safety of several regional analgesic techniques following thoracic surgery: a network meta-analysis of randomized controlled trials

Efficacy and safety of continuous intravenous lidocaine administration as a component of intraoperative analgesia and postoperative intensive care in extensive liver resections

Epidural Analgesia Is Associated with Prolonged Length of Stay After Open HPB Surgery in Over 27,000 Patients

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