General anesthesia versus epidural and general anesthesia in radical cystectomy.
BACKGROUND
The aim of this study is to compare two different anesthetic techniques in radical cystectomy with regard to blood loss, transfusional requirements, intraoperative complications and the quality of analgesia.


METHODS
50 patients scheduled for radical cystectomy were randomized to two groups: group GA - general anesthesia, n = 25 and group CEGA - combined epidural and general anesthesia. The patients were monitored and hemodynamic changes, intraoperative bleeding, transfusional requirements, quality of analgesia and postoperative complications were evaluated.


RESULTS
There were no significant differences between the demographic characteristics of the two groups. Intraoperative bleeding which was 874.8 +/- 190.7 ml in the CEGA group and 1,248.3 +/- 343.4 ml in the GA group was statistically different (p < 0.05). Significantly more intraoperative blood transfusions in terms of units were required in the GA group. Analgesia was better in the CEGA group, with VAS values at 0, 1, 2, 4, 6, 12 and 24 h significantly (p < 0.05) lower than those observed in the GA group. No significant differences in intraoperative hemodynamic parameters or postoperative complications were noted between the two groups.


CONCLUSIONS
Statistically significant differences in intraoperative bleeding were observed between the two groups: CEGA provides lower intraoperative bleeding and a better postoperative analgesia. Major operations such as radical cystectomy, which also is associated with considerable blood loss, a combination of general and epidural anesthesia may allow for less blood loss, with a better postoperative analgesia and without any increase in complications.
Ozyuvaci
Emine
E
Department of Anesthesiology, SSK Okmeydani Educational Hospital, Istanbul, Turkey. ehozyuvaci@bnet.net.tr
Altan
Aysel
A
Karadeniz
Tahir
T
Topsakal
Medih
M
Besisik
Ahmet
A
Yucel
Mehmet
M
D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D002295:Carcinoma, Transitional Cell / Q000601:surgery*; D015653:Cystectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D001749:Urinary Bladder Neoplasms / Q000601:surgery*