Epidural block for treatment of intestinal obstruction--clinical and experimental studies.
Seventy patients with intestinal obstruction were managed with usual conservative treatments and epidural anesthesia to block splanchnic and somatic nervous systems, for nine years from 1981 to 1990. Improvement of clinical symptoms and general conditions was accomplished in 48 patients (68.6%). In these 48 patients, 41 patients (58.6%) had complete remission of intestinal obstruction, showing flatus in 8.3 hours on an average, but seven (10.0%) had incomplete remission. For these seven, after improvements of their clinical symptoms, elective radical operations were performed within three weeks. In 22 (31.4%) patients whose symptoms were not improved at all with the epidural block, emergency exploratory celiotomies were performed, 15.4 hours on an average after the initial epidural block. Indications for surgical intervention of intestinal obstruction were decided by the absent movement of gas in the bowel in a series of plain X-rays. The effectiveness of the epidural block on the motility of the obstructed intestinal loop was experimentally confirmed in monkeys. We suggested that the epidural block, accompanied with usual conservative treatments, be recommended as the initial treatment for intestinal obstruction.
Department of Anesthesiology, Hamanomachi Hospital, Fukuoka, Japan.
Y
Y
Nomoto
T
T
Hirose
K
K
Harano
Y
Y
Taniguchi
M
M
Takasaki
T
T
Totoki