Abstract ID: A08

Abstract Title: The benefits of adding epidural analgesia to general anesthesia: a metaanalysis.

Poster Type: Poster

ABSTRACT BODY

Introduction: The aim of this study was to determine the benefits of postoperative epidural analgesia in patients operated under general anesthesia.

Materials and Methods: Of the 1725 studies identified by a search of the American National Library of Medicine’s Pubmed database up to July 10, 2004, 78 studies including 5616 patients of which 2749 had epidural analgesia were kept for the final analysis.

Results: Epidural analgesia did not reduce the mortality rate (3.41% vs. 3.14%; P=0.68) but decreased the incidences of arrhythmia (P=0.0004) with an overall effect size (OES) of 0.09 (95%CI=0.001-0.17 (P=0.02) and of pneumonia (P=0.002), OES=0.06 (95%CI=0.004-0.13; P=0.009)(Table 1). There was no significant difference in the incidence of deep venous thrombosis, pulmonary embolism, myocardial infarction, cerebrovascular accident, acute pulmonary edema, renal failure, wound infection and reoperation (Table 1). Time to extubation or to first bowel movement, ICU and hospital stays, forced vital capacity and VAS scores at rest or movement at postoperative day one, first 24 hours morphine consumption and maximal blood concentrations of epinephrine, norepinephrine, glucose and cortisol were not statistically significantly modified by epidural analgesia when evaluated by standardized increments (Table 2).

Discussion: Postoperative epidural analgesia does not reduce the mortality rate of patients operated under general anesthesia.

ATTACHED FILES

A08_Guay J-ASRA 2005-Table 1.doc

A08_Guay J-ASRA 2005-Table 2.doc

Reg Anesth Pain Med 2004; 29(2):A08