Rethinking Epidural Anesthesia : From the View Point of Perioperative Efficiency

Suzuki, Toshiyasu

doi:10.2199/jjsca.34.556

Cited by 1 publication

(2 citation statements)

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“…Therefore, from our findings, using EA is beneficial in medical cost optimization. EA has also been reported to have benefits leading to early release and early discharge (Suzuki 2014). Based on past research, EA promotes ADL recovery by appropriately controlling pain, facilitating early weaning, allowing patients to eat without inhibiting intestinal peristalsis, and potentially reducing hospital stay.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…Previous studies have reported that postoperative analgesia with EA for RRP prolongs the length of hospital stay (Mir et al 2013). In addition, EA has been reported to have several advantages, including the ability to adjust the spread of the drug to the target site, superior analgesia during body movement, early release, fewer respiratory complications such as atelectasis, and no suppression of peristalsis of the digestive tract (Suzuki 2014). On the other hand, EA has serious complications such as epidural blood or an epidural abscess caused by the catheter (Yokoyama 2009;Makito et al 2021;).…”

Section: Accepted Manuscript 14mentioning

confidence: 99%

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Effect of Postoperative Pain Management after Robot-Assisted Radical Prostatectomy: A Study on Reducing Hospital Length of Stay and Medical Costs Using Japanese Nationwide Database

Mizuta

Tarasawa

Fushimi

et al. 2023

Tohoku J. Exp. Med.

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Prostate cancer has a high incidence rate. Many articles reported its usefulness with the advent of robotic surgery in 2001. However, epidural analgesia is declining due to the spread of minimally invasive treatment. There have been no studies using nationwide databases on the impact of epidural analgesia use on length of hospital stay and medical costs. Therefore, we used a Japanese national inpatient database from April 2016 to March 2020. The study population included 46,166 patients. We compared a postoperative analgesia management group using epidural analgesia (EA Group: 5,354) and a group not using epidural analgesia (non-EA Group: 40,812). We found significant differences among the two groups regarding the length of stay, Days from Surgery to Discharge, and Inpatient cost of surgery to discharge. Hospital length of stay and postoperative hospital stay was statistically shorter in the EA group than in the non-EA group (11.3 ±2.8 days vs. 12.1 ± 3.1 days, p-value <0.001 and 8.9 ±2.5days vs. 9.3 ±2.7days, p-value <0.001) respectively, and medical costs were also significantly lower in the EA group (￥284,566 vs. ￥294,277, p-value <0.001). Also, the ADL assessment at discharge determined a considerably higher score in the EA group than in the non-EA groups. Epidural analgesia for postoperative pain management largely depends on each medical institution's treatment A c c e p t e d M a n u s c r i p t 4 policy. However, epidural analgesia is declining due to the spread of minimally invasive treatment. Therefore, epidural analgesia should be reconsidered because it can reduce hospital stays and hospitalization costs.

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Section: Accepted Manuscriptmentioning

confidence: 99%

Section: Accepted Manuscript 14mentioning

confidence: 99%