[Fast track in abdominal aortic surgery].
BACKGROUND
The aim of this work is to evaluate the efficacy of a new perioperative approach to improve the outcome and to reduce hospitalisation after abdominal aortic surgery.


METHODS



METHODS
observational study on patients operated from October 1996 to October 1997 (Group 1996), and from November 1997 to November 1998 (group 1998). CENTRE: Anaesthesiology Department of Regional Hospital.


METHODS
historical group: 56 patients surgically treated with abdominal aortic bypass in 1996. CASE CONTROL GROUP: 58 patients surgically treated with abdominal aortic bypass in 1998.


METHODS
group 1996: maintenance of anaesthesia with forane and fentanyl; postoperative infusion of mepivacaine 1% through lumbar epidural catheter. GROUP 1998: preoperative anaesthesia through thoracic (T 4) epidural catheter with infusion of bupivacaine 0.5%; maintenance of anaesthesia with propofol, fentanyl and infusion of bupivacaine 0.125%; postoperative infusion of bupivacaine 0.125%, early rehabilitation care (early removal of nasogastric tube and urinary catheter, early deambulation, feeding and physiotherapy).


RESULTS
analgesia efficacy, day of deambulation, day of removal of the urinary catheter and the nasogastric tube, day of bowel canalization, day of discharge, major complications.


RESULTS
In group 1998 analgesia was better. Furthermore a significant improvement consisted in the earlier removal of the nasogastric tube and the urinary catheter, earlier return of the gastrointestinal function and earlier deambulation. The length of stay is significantly reduced. In group 1998 we have less complications.


CONCLUSIONS
Total intra-venous anaesthesia associated with a thoracic epidural anaesthesia, connected with early rehabilitation may improve the outcome and reduce the length of stay in patients submitted to abdominal aortic surgery.
Renghi
A
A
Ospedale degli Infermi, Biella, Italy.
Gramaglia
L
L
Ciarlo
M
M
Cerioli
S
S
Albani
A
A
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D019091:Critical Pathways; D006801:Humans
Fast track in chirurgia dellaorta addominale.