Effects of combined epidural with general anesthesia on postoperative self-controlled epidural analgesia in patients with upper abdominal surgery

Objective To compare the effect of combined epidural/general anesthesia with general anesthesia alone on postoperative self-controlled epidural analgesia. Methods A randomized, controlled, prospective clinical trial was conducted. Thirty-seven ASAⅠ-Ⅱpatients(≤70 years old) scheduled for gastrectomy were randomly allocated into two groups: general anesthesia group(G group, n = 18) and combined epidural/general anesthesia group(EG group, n = 19). Self-controlled epidural analgesia was used and consumption of analgesics was recorded 2 days postoperatively(POD) with retaining of epidural canula, the quality of analgesia (visual analogue score) 6, 12, 24, 48 h postoperatively at rest were also evaluated. Results Cumulative dosage of fentanyl during operation in G group [(0. 41±0. 08) mg] was higher than that in EG group [(0. 24±0. 03) mg]. VAS in EG group was significantly lower than that in G group 12 and 24 hours postoperatively(12 h: 3. 4±2. 5 vs 4. 5±1. 5; 24 h: 3. 1±2. 1 vs 4. 2±1. 0). The total analgesic consumption was significantly less in EG group [POD 1: (55. 2±12. 9) ml, vs (67. 5±9. 0) mL; POD 2 : (39. 9±4. 2) mL vs (52. 4±8. 0) mL]. Conclusions Combined epidural/general anesthesia can improve the quality of self-controlled epidural analgesia in POD 1 and reduce the consumption of analgesics 2 days postoperatively.