Anaesthesia for cystectomy. A comparison of two anaesthetic techniques

Sixty-two patients who underwent radical cystectomy for deeply infiltrating cancer of the bladder were reviewed. Twenty-four received an epidural anaesthetic and 38 a conventional muscle relaxant and fentanyl anaesthetic. The epidural technique was found to offer advantages because of its hypotensive effects reducing blood loss intra-operatively and its use to provide analgesia after surgery. A high incidence of complications accompanied the surgery and frail patients (below 50 kg) and those with symptomatic respiratory disease had a high mortality. Greater attention to pre-operative care of such patients is indicated.