Post-Operative Thoracic Epidural Analgesia and Incidence of Major Complications according to Specific Safety Standardized Documentation: A Large Retrospective Dual Center Experience

Abstract

(1) Background: Thoracic epidural analgesia is considered the gold standard in post-operative pain management following thoracic surgery. This study was designed to explore the safety of thoracic epidural analgesia and to quantify the incidence of its post-operative complications and side effects in patients undergoing thoracotomy for major surgery, such as resection of lung malignancies and lung transplantation. (2) Methods: This is a retrospective, dual-center observational study including patients that underwent major thoracic surgery including lung transplantation and received concurrent placement of thoracic epidural catheters for post-operative analgesia. An electronic system of referral and documentation of complications was used, and information was retrieved from our electronic critical care charting system. (3) Results: In total, 1145 patients were included in the study. None of the patients suffered any major complication, including hematoma, abscess, or permanent nerve damage. (4) Conclusions: the present study showed that in experienced centers, post-operative epidural analgesia in patients with thoracotomy is a safe technique, manifesting minimal, none-serious complications.

Loco-Regional Anesthesia for Pain Management in Robotic Thoracic Surgery

“…There are potential complications and considerations specifically associated with the use of TEA in robotic thoracic surgery [ 28 ]: Hemodynamic Instability: The administration of local anesthetics into the epidural space can lead to sympathetic nerve blockade, which may result in vasodilation and hypotension. Careful monitoring and management of the patient’s fluid status and hemodynamics are required to prevent and treat hypotension [ 29 , 30 ].…”