title: Comparison of pain management after laparoscopic distal gastrectomy with and without epidural analgesia.
abstract: OBJECTIVE
  The optimal analgesia following laparoscopic distal gastrectomy (LDG) has not been determined; moreover, it has been unclear whether epidural anesthesia has benefits for laparoscopic surgery. In this study, we evaluated the effectiveness of epidural analgesia after LDG.
  
  
  METHODS
  This retrospective study included 84 patients who underwent LDG for gastric cancer. Patients received either combined thoracic epidural and general anesthesia (Epidural group, n = 34) or general anesthesia alone (No epidural group, n = 50). We recorded data on the patients, surgery, postoperative outcomes and anesthesia-related complications.
  
  
  RESULTS
  In the Epidural group, the first day of flatus was significantly earlier (2.21 vs. 2.44 days, p = 0.045) and the number of additional doses of analgesics was significantly lower (2.85 vs. 4.86 doses, p = 0.007) than in the No epidural group. Postoperative urinary retention occurred at a significantly higher rate in the Epidural group (n = 7; 20.6 %) than in the No epidural group (p < 0.001).
  
  
  CONCLUSIONS
  Epidural anesthesia may reduce the need for additional analgesics after LDG, but increases the risk of urinary retention.
authors: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2, E-2, Yamadaoka, Suita-city, Osaka, 565-0871, Japan.
authors: Yoshitomo
authors: Y
authors: Yanagimoto
authors: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2, E-2, Yamadaoka, Suita-city, Osaka, 565-0871, Japan. stakiguchi@gesurg.med.osaka-u.ac.jp.
authors: Shuji
authors: S
authors: Takiguchi
authors: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2, E-2, Yamadaoka, Suita-city, Osaka, 565-0871, Japan.
authors: Yasuhiro
authors: Y
authors: Miyazaki
authors: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2, E-2, Yamadaoka, Suita-city, Osaka, 565-0871, Japan.
authors: Jota
authors: J
authors: Mikami
authors: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2, E-2, Yamadaoka, Suita-city, Osaka, 565-0871, Japan.
authors: Tomoki
authors: T
authors: Makino
authors: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2, E-2, Yamadaoka, Suita-city, Osaka, 565-0871, Japan.
authors: Tsuyoshi
authors: T
authors: Takahashi
authors: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2, E-2, Yamadaoka, Suita-city, Osaka, 565-0871, Japan.
authors: Yukinori
authors: Y
authors: Kurokawa
authors: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2, E-2, Yamadaoka, Suita-city, Osaka, 565-0871, Japan.
authors: Makoto
authors: M
authors: Yamasaki
authors: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2, E-2, Yamadaoka, Suita-city, Osaka, 565-0871, Japan.
authors: Hiroshi
authors: H
authors: Miyata
authors: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2, E-2, Yamadaoka, Suita-city, Osaka, 565-0871, Japan.
authors: Kiyokazu
authors: K
authors: Nakajima
authors: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2, E-2, Yamadaoka, Suita-city, Osaka, 565-0871, Japan.
authors: Masaki
authors: M
authors: Mori
authors: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2, E-2, Yamadaoka, Suita-city, Osaka, 565-0871, Japan.
authors: Yuichiro
authors: Y
authors: Doki
mesh_terms: D000368:Aged; D000700:Analgesics / Q000008:administration & dosage; D000767:Anesthesia, Epidural / Q000009:adverse effects; D000768:Anesthesia, General; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D005743:Gastrectomy; D006801:Humans; D007262:Infusions, Intravenous; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods*; D011182:Postoperative Care; D012189:Retrospective Studies; D012306:Risk; D013274:Stomach Neoplasms / Q000601:surgery*; D016055:Urinary Retention / Q000209:etiology
chemical_list: D000700:Analgesics; D005283:Fentanyl
keywords: Epidural anesthesia; Laparoscopic distal gastrectomy; Urinary retention