title: Awake epidural anesthesia is effective and safe in the high-risk colectomy patient.
abstract: OBJECTIVE
  This study was designed to examine the feasibility and safety of performing open colectomy using awake epidural anesthesia in high-risk patients with comorbid illnesses.
  
  
  METHODS
  We retrospectively compared 15 high-risk patients who underwent colectomy using awake epidural anesthesia with 17 lower risk colectomy patients who received conventional general endotracheal anesthesia. All patients were operated on consecutively during the same time period by the same surgeon.
  
  
  RESULTS
  Based on the number of coexisting diseased organ systems and by a weighted multifactorial index of operative risk, the patients receiving awake epidural anesthesia were significantly more ill than the patients receiving general anesthesia. No differences in complications, length of operative procedure, or number of lymph nodes in cancer specimens were found between the two groups. There was a trend favoring the epidural technique when operative blood loss, length of postoperative hospital stay, and return of bowel function were considered.
  
  
  CONCLUSIONS
  Awake epidural anesthesia is a safe and effective technique in high-risk patients undergoing colectomy and achieves an operative risk that compares favorably with healthier patients receiving general anesthesia.
authors.affiliation: Department of Surgery, Pennsylvania State University, College of Medicine, Milton S. Hershey Medical Center, Hershey 17033.
authors.forename: W A
authors.initials: WA
authors.lastname: Koltun
authors.forename: K J
authors.initials: KJ
authors.lastname: McKenna
authors.forename: G
authors.initials: G
authors.lastname: Rung
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D003082:Colectomy / Q000379:methods*; D003108:Colonic Diseases / Q000150:complications / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome