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British Journal of Anaesthesia, 2004, Vol. 92, No. 1 4-6
© 2004 The Board of Management and Trustees of the British Journal of Anaesthesia

Editorial II

Does epidural analgesia improve surgical outcome?

J. C. Ballantyne1

1 Harvard Medical School, Massachusetts General Hospital Pain Center, 15 Parkman Street, WACC 333, Boston, MA 02114, USA E-mail: jballantyne{at}partners.org

{dagger}LMA® is the property of Intavent Limited.

The first 150 words of the full text of this article appear below.

When the safety and efficacy of neuraxial opioid administration was established in humans in the late 1970s,1 the utility of postoperative epidural analgesia increased markedly. The opioid provided good analgesia without the high doses of local anaesthetic that were previously used, thus allowing patients to retain their mobility while receiving effective epidural analgesia. As the use of epidurals for postoperative pain became more widespread, clinicians began to assess whether epidural analgesia would improve surgical outcome. The superior analgesia of epidural vs systemic analgesia during the postoperative period, at least after intra-abdominal and intrathoracic procedures, was quickly confirmed by multiple randomized trials.2 However, it was much more difficult to show benefit in terms of improvement in surgical outcome, and early trials had mixed results.

 Efforts to determine the true benefits of postoperative epidural analgesia are often confounded when epidural anaesthesia is used during surgery. It is common in clinical practice, and . . . [Full Text of this Article]


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