title: [Combined epidural anaesthesia as an alternative to inhalation anaesthesia as exemplified in radical lymphadenectomy in testicular malignomas (author's transl)].
abstract: In a retrospective study of retroperitoneal lymph-adenectomy it was investigated whether the choice of anaesthesia and the difference in management of postoperative pain alleviation does influence the postoperative course. In comparing group I (n = 43), patients anaesthesized with volatile anaesthetics (enflurance, halothane) while postoperative pain relief was obtained by meperidine and pentazocine and group II (n = 28), anaesthesized with a high epidural block combined with light narcosis with oxygen, nitrous oxygen and diazepam, while postoperative pain relief was obtained by a continuous epidural block we found: In comparison to group I the stay in group II was shorter. There was one patient in group II with intestinal obstruction, but in group I were seven patients with clinical signs of intestinal obstruction. In group I the evaluation of the bowel took place after 36 hours, in group II after 20 hours. One patient in group I died after three days because of pneumonia combined with intestinal obstruction. The consumption of meperidine and pentazocine in comparison group II to group I were diminished to round about 85%. We think that there is a direct relation between anaesthesia, postoperative pain alleviation and the postoperative course. High epidural anaesthesia in combination with light anaesthesia and postoperative epidural analgesia seems to be better than inhalational anaesthesia for the patients we explored in our retrospective study.
mesh_terms: D000767:Anesthesia, Epidural / Q000379:methods*; D000769:Anesthesia, Inhalation; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008614:Meperidine / Q000627:therapeutic use; D010149:Postoperative Pain / Q000188:drug therapy; D010423:Pentazocine / Q000627:therapeutic use; D012187:Retroperitoneal Space / Q000601:surgery; D013736:Testicular Neoplasms / Q000601:surgery*
chemical_list: D008614:Meperidine; D010423:Pentazocine
vernacular_title: Kombinierte Periduralanästhesie als Alternative zur Intubationsnarkose am Beispiel der ausgedehnten radikalen Lymphadenektomie bei Hodentumoren.