Analgesia epidurale toracica e chirurgica dell'aorta addominale

Background: The surgical stress of abdominal aortic procedures can lead to multiple organ failure in the postoperative period. The aim of the present study is to assess the use of intra- and postoperative thoracic epidural anaesthesia to control the response to surgical stress. Methods: A retrospective clinical study was conducted on 80 patients given elective subrenal aortic grafts. The patients were divided into two groups: 47 given blended anaesthesia involving intra- and postoperative thoracic epidural analgesia (Group A) and 33 given blended general anaesthesia combined with postoperative opiate analgesia (Group B). Intra- and postoperative complications and mean postoperative hospital stay were then analysed. Results: Fewer intraoperative complications were found in Group A including hypertension, delayed awakening and time in Intensive Care. Group A also revealed fewer cases of nausea, vomiting, pain and high blood pressure as well as faster recovery of gastroenteric function and shorter postoperative hospital stays than Group B. Conclusions: It is therefore concluded that a multimodal, multidisciplinary approach involving intra- and postoperative thoracic epidural anaesthesia appears to improve outcome and reduce morbidity and hospital stay in patients subjected to abdominal aortic surgery.