Postoperative pain relief using thoracic epidural analgesia

outstanding success and disappointing failures

G. A. McLeod (Lead / Corresponding author), H. T. O. Davies, N. Munnoch, J. Bannister, W. MacRae

    Research output: Contribution to journalArticle

    75 Citations (Scopus)

    Abstract

    Six hundred and forty patients received epidural analgesia for postoperative pain relief following major surgery in the 6-year period 1993-1998. Although satisfactory pain relief was achieved in over two-thirds of patients for a median duration of 44 h after surgery, one-fifth of patients (133 individuals) still experienced poor pain relief. Almost one out of three patients (194 individuals) had a problem with their epidural. Eighty-three patients (13%) suffered a technical failure and 84 (13%) patients had their epidurals removed at night time when pain-free because of pressure on beds. Seven patients had their epidural replaced and subsequently experienced excellent pain relief for a median of 77 h. Lack of resources prevented a further 480 patients from receiving the potential benefits of epidural analgesia. These results would suggest that the practical problems of delivering an epidural service far outweigh any differences in drug regimens or modes of delivery of epidural solutions.
    Original languageEnglish
    Pages (from-to)75-81
    Number of pages7
    JournalAnaesthesia
    Volume56
    Issue number1
    DOIs
    Publication statusPublished - 2001

    Fingerprint

    Epidural Analgesia
    Postoperative Pain
    Thorax
    Pain
    Pressure

    Keywords

    • Aged
    • Analgesia, Epidural
    • Equipment failure
    • Humans
    • Intensive care
    • Middle aged
    • Pain measurement
    • Pain, Postoperative
    • Treatment failure
    • Treatment outcome

    Cite this

    McLeod, G. A. ; Davies, H. T. O. ; Munnoch, N. ; Bannister, J. ; MacRae, W. / Postoperative pain relief using thoracic epidural analgesia : outstanding success and disappointing failures. In: Anaesthesia. 2001 ; Vol. 56, No. 1. pp. 75-81.
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    abstract = "Six hundred and forty patients received epidural analgesia for postoperative pain relief following major surgery in the 6-year period 1993-1998. Although satisfactory pain relief was achieved in over two-thirds of patients for a median duration of 44 h after surgery, one-fifth of patients (133 individuals) still experienced poor pain relief. Almost one out of three patients (194 individuals) had a problem with their epidural. Eighty-three patients (13{\%}) suffered a technical failure and 84 (13{\%}) patients had their epidurals removed at night time when pain-free because of pressure on beds. Seven patients had their epidural replaced and subsequently experienced excellent pain relief for a median of 77 h. Lack of resources prevented a further 480 patients from receiving the potential benefits of epidural analgesia. These results would suggest that the practical problems of delivering an epidural service far outweigh any differences in drug regimens or modes of delivery of epidural solutions.",
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    Postoperative pain relief using thoracic epidural analgesia : outstanding success and disappointing failures. / McLeod, G. A. (Lead / Corresponding author); Davies, H. T. O.; Munnoch, N. ; Bannister, J.; MacRae, W.

    In: Anaesthesia, Vol. 56, No. 1, 2001, p. 75-81.

    Research output: Contribution to journalArticle

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