Combined anesthesia for esophageal resection operations

OBJECTIVE: To view combined anesthesia benefits versus general anesthesia and to compare postoperative epidural analgesia and patient-controlled analgesia with intravenous morphine. MATERIAL AND METHODS: Twenty four patients scheduled for elective thoracoabdominal esophagectomy were randomized to T (n=12) and K (n=12) groups. Group T patients received epidural analgesia with 0.125 percent bupivocaine and morphine after combined general-epidural anesthesia and group K patients received intravenous patient-controlled analgesia with morphine after general anesthesia. The patients were monitored for operation and extubation time, for postoperative pain and length of intensive care unite (ICU) stay. RESULTS: T group patients received 79 percents less narcotics than K group. At rest there were no differences in pain relief between the groups. Pain scores at mobilization showed a significantly lower value in the T group. Patients in T group were tracheally extubated earlier (mean 210 minutes vs 380 min.) after admission to the ICU and discharged from the ICU earlier (mean 2.3 vs 4.3 days). CONCLUSIONS: Combined anesthesia and epidural analgesia improve overall outcome, provide better postoperative pain relief, shorten the intubation time and intensive care stay in patients undergoing esophageal resection operations.