Epidural analgesia following upper abdominal surgery : United Kingdom practice
BACKGROUND: Epidural Analgesia (EA) may be used to provide pain relief after upper abdominal surgery. A variety of drugs and combinations may be used. Potential side effects lead some to believe EA should be restricted to high care areas.
METHOD: The use of EA following upper abdominal surgery is surveyed in 214 hospitals in the United Kingdom by means of a postal questionnaire.
RESULTS: Sixty-seven percent use EA frequently and 3% not at all. The low thoracic site is the most commonly used, by 65%. Forty-eight percent use a combination of sites. EA is most frequently achieved using a mixture of an opioid and a local anaesthetic (97%). No other agents are used. Fentanyl and diamorphine are the opioids used most widely (61% and 52% departments, respectively) in combination with local anaesthetic. Subcutaneous heparin is regularly used in 89% of departments. In 43%, the epidural is sited shortly after administering heparin. Use of EA is restricted solely to intensive or high-care units in 46% of hospitals. In 82% of departments, EA is continued for up to 72 h. Ninety-six percent of departments use continuous epidural infusions in the post-operative period. Adjunct analgesia includes non-steroidal anti-inflammatory drugs in 50% of departments. An anaesthetist supervises EA in 89% of hospitals. EA is considered to be the best mode of analgesia available by 80% of respondents.
CONCLUSION: EA is widely used in the United Kingdom following upper abdominal surgery. A degree of consensus exists on the choice of drug types, their method of administration and duration. There is no consensus as to whether the technique should be used on a general ward, which opioid should be used or the timing of heparin.
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
1997 |
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| Erschienen: |
1997 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:41 |
|---|---|
| Enthalten in: |
Acta anaesthesiologica Scandinavica - 41(1997), 1 Pt 1 vom: 27. Jan., Seite 18-24 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Cook, T M [VerfasserIn] |
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| Themen: |
Analgesics, Opioid |
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| Anmerkungen: |
Date Completed 08.05.1997 Date Revised 14.08.2019 published: Print Citation Status MEDLINE |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM090235029 |
|---|
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| 100 | 1 | |a Cook, T M |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Epidural analgesia following upper abdominal surgery |b United Kingdom practice |
| 264 | 1 | |c 1997 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ohne Hilfsmittel zu benutzen |b n |2 rdamedia | ||
| 338 | |a Band |b nc |2 rdacarrier | ||
| 500 | |a Date Completed 08.05.1997 | ||
| 500 | |a Date Revised 14.08.2019 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Epidural Analgesia (EA) may be used to provide pain relief after upper abdominal surgery. A variety of drugs and combinations may be used. Potential side effects lead some to believe EA should be restricted to high care areas | ||
| 520 | |a METHOD: The use of EA following upper abdominal surgery is surveyed in 214 hospitals in the United Kingdom by means of a postal questionnaire | ||
| 520 | |a RESULTS: Sixty-seven percent use EA frequently and 3% not at all. The low thoracic site is the most commonly used, by 65%. Forty-eight percent use a combination of sites. EA is most frequently achieved using a mixture of an opioid and a local anaesthetic (97%). No other agents are used. Fentanyl and diamorphine are the opioids used most widely (61% and 52% departments, respectively) in combination with local anaesthetic. Subcutaneous heparin is regularly used in 89% of departments. In 43%, the epidural is sited shortly after administering heparin. Use of EA is restricted solely to intensive or high-care units in 46% of hospitals. In 82% of departments, EA is continued for up to 72 h. Ninety-six percent of departments use continuous epidural infusions in the post-operative period. Adjunct analgesia includes non-steroidal anti-inflammatory drugs in 50% of departments. An anaesthetist supervises EA in 89% of hospitals. EA is considered to be the best mode of analgesia available by 80% of respondents | ||
| 520 | |a CONCLUSION: EA is widely used in the United Kingdom following upper abdominal surgery. A degree of consensus exists on the choice of drug types, their method of administration and duration. There is no consensus as to whether the technique should be used on a general ward, which opioid should be used or the timing of heparin | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 7 | |a Analgesics, Opioid |2 NLM | |
| 650 | 7 | |a Anesthetics, Local |2 NLM | |
| 700 | 1 | |a Eaton, J M |e verfasserin |4 aut | |
| 700 | 1 | |a Goodwin, A P |e verfasserin |4 aut | |
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