Patients who received epidural analgesia for open colectomy experienced lower rates of myocardial infarction, pulmonary complications, pneumonia and shorter hospital length of stay (LOS) than those who did not.
Kenneth Cummings, MD, an anesthesiologist at the Cleveland Clinic, in Ohio, presented the analysis of regional anesthetic techniques following surgery, that was conducted with a multidisciplinary team of collaborators.
Based on previous research that found epidural analgesia led to increased survival after major surgeries, the team of researchers wanted to establish if there was a reduction in the immediate complication rate that would make people more likely to survive in the long term. The retrospective analysis revealed no association between epidural analgesia and few complications after colectomy. However, there was a significant association with shorter hospital LOS (time to discharge hazard ratio, 1.11; 98.75% CI, 1.04-1.19; P<0.001) and fewer cardiopulmonary complications (odds ratio, 0.50; 95% CI, 0.29-0.85; P=0.01) in open colectomy.
Dr. Cummings presented the findings at the 2017 annual meeting of the American Society of Anesthesiologists (abstract A1080). He explained that they looked at data from two groups collected from the American College of Surgeons National Surgical Quality Improvement Program in 2014. What the researchers found was that patients who received epidurals during open colectomy had lower rates of complications, such as myocardial infarction, and had shorter hospital LOS.
“The findings support the longer-term observation that patients [who received epidurals] survive more, but also sheds a little insight as to why,” Dr. Cummings said. “Moving forward, this is the kind of hypothesis generation that would be the basis for prospective trials.”