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

Hiroshi Saeki, Hiroshi Ishimura, Hidefumi Higashi, Dai Kitagawa, Junko Tanaka, Riichiroh Maruyama, Hidenori Katoh, Hirofumi Shimazoe, Kouta Yamauchi, Hitoshi Ayabe, Yoshihiro Kakeji, Masaru Morita, Yoshihiko Maehara

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17 Citations (Scopus)

Abstract

Purpose: 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. Methods: 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. Results: 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). Conclusions: Early rehabilitation is facilitated with intensive PCEA, while it also improves postoperative management and reduces hospitalization after esophageal surgery.

Original languageEnglish
Pages (from-to)476-480
Number of pages5
JournalSurgery today
Volume39
Issue number6
DOIs
Publication statusPublished - Jun 1 2009

All Science Journal Classification (ASJC) codes

  • Surgery

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    Saeki, H., Ishimura, H., Higashi, H., Kitagawa, D., Tanaka, J., Maruyama, R., Katoh, H., Shimazoe, H., Yamauchi, K., Ayabe, H., Kakeji, Y., Morita, M., & Maehara, Y. (2009). Postoperative management using intensive patient-controlled epidural analgesia and early rehabilitation after an esophagectomy. Surgery today, 39(6), 476-480. https://doi.org/10.1007/s00595-008-3924-2