Improved peri-operative outcomes with epidural analgesia in patients undergoing a pancreatectomy: a nationwide analysis

HPB : the Official Journal of the International Hepato Pancreato Biliary Association
Dominic E SanfordRyan C Fields

Abstract

In spite of limited evidence demonstrating a benefit, epidural analgesia (EA) is often used for patients undergoing a pancreatectomy. In the present study, the impact of epidural analgesia on post-operative outcomes after a pancreatectomy is examined. Utilizing the Nationwide Inpatient Sample, the effect of EA on peri-operative outcomes after a pancreatectomy was examined. Multivariable logistic and linear regression with propensity score matching were utilized for risk adjustment. From 2008-2011, 12,440 patients underwent a pancreatectomy. Of these, 1130 (9.1%) patients received epidural analgesia. Using univariate comparison, patients receiving EA had a significantly decreased length of stay (LOS), hospital charges and post-operative inpatient mortality. In multivariate analyses, EA was independently associated with a decreased post-operative LOS (adjusted mean difference = -1.19 days, P < 0.001), decreased hospital charges (adjusted mean difference = -$16,814, P = 0.002) and decreased post-operative inpatient mortality [adjusted odds ratio (OR) = 0.42, P < 0.001]. Using 1:1 propensity score matching, patients who received an EA (n = 1070) had significantly decreased post-operative LOS (11.0 versus 12.1 days, P = 0.011), lowe...Continue Reading

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Citations

Jan 15, 2016·American Journal of Surgery·Neda AminiTimothy M Pawlik
Dec 9, 2015·Best Practice & Research. Clinical Anaesthesiology·Andreas GüldnerMarcelo Gama de Abreu
Sep 17, 2019·Journal of Perioperative Practice·Engy T SaidRodney A Gabriel
Jul 26, 2017·Plastic and Reconstructive Surgery. Global Open·Ibrahim KhansaJeffrey E Janis
Jan 27, 2019·World Journal of Surgery·David A MahviEdward E Whang
Sep 26, 2017·The Cochrane Database of Systematic Reviews·Lise J EstcourtSimon J Stanworth
Feb 28, 2019·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Jesse V GroenJ Sven D Mieog
Jul 30, 2020·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Lyonell B KoneAjay V Maker
Oct 17, 2020·The Journal of Surgical Research·Leah K WinerSameer H Patel
Jul 6, 2019·The Journal of Surgical Research·Hannah M PhelpsHarold N Lovvorn

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