Epidural Anesthesia? No of Course

J. Fazakas, Sz Tóth, B. Füle, A. Smudla, T. Mándli, M. Radnai, A. Doros, B. Nemes, L. Kóbori

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Although the contraindications for thoracic epidural anesthesia (TEA) are well defined, the debate continues about whether TEA improves outcomes. Pro and con trials and a metaanalysis in the past have yielded equivocal results; they did not deal with new vascular intervention or drugs. The benefit of TEA in surgery is to provide analgesia. In subgroups, TEA can decrease the mortality and morbidity. In contrast, the cost can increase in the situation of a complication that is opposite to the side effects is rare, but the impairment caused by them is out of proportion to the benefits. Primary or secondary prophylaxis with antithrombotic drugs is increasing in developed countries because of the increasing cardiovascular interventions and aging of the population. The neuroaxial guidelines are useful, but the changing of the coagulation profile after hepatectomy is not included in them. The decision to use TEA in liver surgery must be individualized with steps planned from the beginning. TEA suitability is based on an evaluation of the contraindications, comorbidities, coagulation profiles, hepatic reserve, and balance of benefits and risks. The insertion or withdrawal of the epidural catheter should be made with care according to the neuroaxial guidelines and in the presence of a normal TEG. The decreasing level of prothrombin content and platelet counts after hepatectomy should be closely monitored every 2 to 5 days.

Original languageEnglish
Pages (from-to)1216-1217
Number of pages2
JournalTransplantation Proceedings
Volume40
Issue number4
DOIs
Publication statusPublished - May 2008

Fingerprint

Epidural Anesthesia
Thorax
Hepatectomy
Guidelines
Liver
Prothrombin
Platelet Count
Developed Countries
Pharmaceutical Preparations
Analgesia
Blood Vessels
Comorbidity
Catheters
Morbidity
Costs and Cost Analysis
Mortality
Population

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Fazakas, J., Tóth, S., Füle, B., Smudla, A., Mándli, T., Radnai, M., ... Kóbori, L. (2008). Epidural Anesthesia? No of Course. Transplantation Proceedings, 40(4), 1216-1217. https://doi.org/10.1016/j.transproceed.2008.03.109

Epidural Anesthesia? No of Course. / Fazakas, J.; Tóth, Sz; Füle, B.; Smudla, A.; Mándli, T.; Radnai, M.; Doros, A.; Nemes, B.; Kóbori, L.

In: Transplantation Proceedings, Vol. 40, No. 4, 05.2008, p. 1216-1217.

Research output: Contribution to journalArticle

Fazakas, J, Tóth, S, Füle, B, Smudla, A, Mándli, T, Radnai, M, Doros, A, Nemes, B & Kóbori, L 2008, 'Epidural Anesthesia? No of Course', Transplantation Proceedings, vol. 40, no. 4, pp. 1216-1217. https://doi.org/10.1016/j.transproceed.2008.03.109
Fazakas J, Tóth S, Füle B, Smudla A, Mándli T, Radnai M et al. Epidural Anesthesia? No of Course. Transplantation Proceedings. 2008 May;40(4):1216-1217. https://doi.org/10.1016/j.transproceed.2008.03.109
Fazakas, J. ; Tóth, Sz ; Füle, B. ; Smudla, A. ; Mándli, T. ; Radnai, M. ; Doros, A. ; Nemes, B. ; Kóbori, L. / Epidural Anesthesia? No of Course. In: Transplantation Proceedings. 2008 ; Vol. 40, No. 4. pp. 1216-1217.
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