Local versus epidural anesthesia in fast-track abdominal aortic surgery

Area of Science:

• Anesthesiology
• Surgical Innovation

Background:

• Epidural anesthesia/analgesia is standard for major surgeries.
• Fast-track surgery aims for rapid patient recovery.
• Exploring alternatives to epidural techniques is crucial for optimizing patient care.

Purpose of the Study:

• To evaluate continuous wound infiltration as an alternative to thoracic epidural anesthesia/analgesia.
• To compare pain management and recovery in patients undergoing mini-invasive abdominal aortic surgery.
• To assess short-term and long-term postoperative outcomes between the two anesthesia techniques.

Main Methods:

• Prospective randomized study at a university hospital.
• Sixty patients undergoing fast-track abdominal aortic surgery were included.
• Comparison between thoracic epidural infusion (PERI group) and continuous local wound infiltration (LOC group).

Main Results:

• Both groups experienced low pain scores.
• The local wound infiltration group required higher doses of anesthetic/analgesic drugs, including bupivacaine.
• Postoperative recovery parameters (ambulation, feeding, discharge day, hospital stay) were similar between groups.
• No significant difference in wound complication incidence at 2-year follow-up.

Conclusions:

• Continuous wound infiltration provides effective pain control, comparable to thoracic epidural analgesia.
• Postoperative recovery and long-term outcomes are similar for both methods.
• Local wound infiltration may necessitate higher anesthetic drug volumes.