title: Combined epidural and general anaesthesia versus general anaesthesia for abdominal aortic surgery: a prospective randomised trial.
abstract: Fifty patients undergoing elective abdominal aortic surgery were randomised to receive either combined epidural and general anaesthesia and postoperative epidural analgesia (CEGA) or general anaesthesia and postoperative intravenous morphine infusion (GA). Prospective data was collected in order to compare the two groups. This included intraoperative cardiovascular changes and postoperative complications. The use of intraoperative vasopressors was significantly higher in the CEGA group (P < 0.01) but the use of intravenous glyceryl trinitrate was significantly lower (P < 0.01). There was no significant difference between groups in regard to blood loss, volume replacement or in the number of patients requiring postoperative ventilation. Two patients in the CEGA group died postoperatively compared to one in the GA group (not significant). There was no significant difference between groups in the total number or type of postoperative complications. Combining epidural anaesthesia with general anaesthesia altered intraoperative cardiovascular management but did not affect postoperative outcome.
authors.affiliation: Department of Anaesthesia, St Vincent's Hospital, Melbourne, Victoria.
authors.forename: M J
authors.initials: MJ
authors.lastname: Davies
authors.forename: B S
authors.initials: BS
authors.lastname: Silbert
authors.forename: P J
authors.initials: PJ
authors.lastname: Mooney
authors.forename: R H
authors.initials: RH
authors.lastname: Dysart
authors.forename: A C
authors.initials: AC
authors.lastname: Meads
mesh_terms: D000368:Aged; D000698:Analgesia / Q000379:methods*; D015360:Analgesia, Epidural; D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D001012:Aorta, Abdominal / Q000601:surgery; D001018:Aortic Diseases / Q000601:surgery*; D002045:Bupivacaine / Q000008:administration & dosage; D004809:Ephedrine / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D007430:Intraoperative Care; D008297:Male; D008680:Metaraminol / Q000627:therapeutic use; D009020:Morphine / Q000008:administration & dosage; D005996:Nitroglycerin / Q000627:therapeutic use; D010149:Postoperative Pain / Q000517:prevention & control; D011183:Postoperative Complications; D011446:Prospective Studies
chemical_list: D009020:Morphine; D008680:Metaraminol; D005996:Nitroglycerin; D004809:Ephedrine; D002045:Bupivacaine