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Effect of epidural and general anaesthesia compared with general anaesthesia alone in large bowel anastomoses. A
P Ryan1, S A Schweitzer, R J Woods
1Colorectal Unit, St. Vincent's Hospital, Melbourne, Australia.
Objective:
To find out whether patients did better after operations that entailed a large bowel anastomosis if they were given combined epidural and general anaesthesia with spontaneous ventilation rather than standard general anaesthesia with muscle relaxation and ventilation.
Design:
Prospective randomised trial.
Setting:
Specialist unit, teaching hospital.
Subjects:
80 patients undergoing large bowel anastomoses.
Main Outcome Measures:
Incidence of chest infection, wound infection, anastomotic breakdown, urinary tract infection, deep vein thrombosis, pulmonary embolism, median hospital stay and death.
Results:
There were no differences between the groups, but the results were better during the trial period (1985-89) than during the period 1978-83.
Conclusion:
Factors that influence anastomotic healing are complex and improved surgical techniques, postoperative monitoring and patient care may account for the improvement in results compared with the earlier period.