Postoperative management using intensive patient-controlled epidural analgesia and early rehabilitation after an esophagectomy

被引：22

作者：

Saeki, Hiroshi ^{[1
,2
]}

Ishimura, Hiroshi ^{[3
]}

Higashi, Hidefumi ^{[2
]}

Kitagawa, Dai ^{[2
]}

Tanaka, Junko ^{[2
]}

Maruyama, Riichiroh ^{[2
]}

Katoh, Hidenori ^{[2
]}

Shimazoe, Hirofumi ^{[4
]}

Yamauchi, Kouta ^{[4
]}

Ayabe, Hitoshi ^{[4
]}

Kakeji, Yoshihiro ^{[1
]}

Morita, Masaru ^{[1
]}

Maehara, Yoshihiko ^{[1
]}

机构：

[1] Kyushu Univ, Grad Sch Med Sci, Dept Surg & Sci, Higashi Ku, Fukuoka 8128582, Japan

[2] Nippon Steel Yawata Mem Hosp, Dept Surg, Kitakyushu, Fukuoka, Japan

[3] Nippon Steel Yawata Mem Hosp, Dept Anesthesia, Kitakyushu, Fukuoka, Japan

[4] Nippon Steel Yawata Mem Hosp, Dept Rehabil, Kitakyushu, Fukuoka, Japan

来源：

SURGERY TODAY | 2009年 / 39卷 / 06期

关键词：

Esophagectomy; Thoracic epidural analgesia; Patient-controlled analgesia; Postoperative complications; Hospital stay; THORACIC ESOPHAGECTOMY; VASCULAR-SURGERY; PAIN RELIEF; ANESTHESIA; INHIBITOR; CANCER; MORBIDITY;

D O I：

10.1007/s00595-008-3924-2

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Patient-controlled epidural analgesia (PCEA) was developed for use after surgery for thoracic esophageal cancer to relieve wound pain, introduce early rehabilitation, and provide an uneventful postoperative recovery. This retrospective study investigated 22 patients who underwent esophageal surgery to determine the efficacy of postoperative management with PCEA. In the PCEA group (n = 12), patients had two epidural catheters inserted to cover both the thoracic and abdominal incision with a patient-controlled bolus capability. Postoperative mechanical ventilation was administered in all cases in the control group (n = 10). On the other hand, this was only necessary in two patients in the PCEA group. The amount of time the patients stayed in the intensive care unit and the hospital was significantly shorter in the PCEA group than in the control group (P < 0.001 and P < 0.01, respectively). Respiratory complications occurred in four patients in the control group, and none in the PCEA group. The mean number of supplemental analgesics administered for breakthrough pain until the 7th postoperative day was 5.5 in the control group, and 1.3 in the PCEA group (P < 0.001). Early rehabilitation is facilitated with intensive PCEA, while it also improves postoperative management and reduces hospitalization after esophageal surgery.

引用

页码：476 / 480

页数：5

共 16 条

[1] Neutrophil elastase inhibitor (Sivelestat) preserves antitumor immunity and reduces the inflammatory mediators associated with major surgery [J].