Epidural Post-Operative Analgesia in Major Urologic Surgery: Our Experiences

Abstract

Pulmonary, cardiovascular, gastrointestinal and urinary dysfunctions are among the physiologic outcomes of surgical lesions and stress, as well as metabolic, muscular and neuroendocrine disorders.

Our purpose is to prevent such complications in order to optimize the healing process and improve the patient's satisfaction through the application of a post-operative codified analgesia protocol allowing the combined use of local anaesthetics and morphine by both epidural bolus injection and elastomeric pump.

All the patients enrolled underwent the same anaesthetic program: the data processing emphasizes the satisfactory analgesic results of the treatment. More than 80% of the patients did not feel pain at awakening, up to 98.5% during the following hours; one patient only was still complaining 96 hours after surgery.

This excellent analgesic function results in an extremely low rate of severe post-operative complications, despite the fact that patients underwent radical and often prolonged surgery (31% was affected by severe systemic pathology).

We encountered a negligible and easy-to-treat complication rate secondary to the analgesic technique or to the infused drugs; the epidural analgesia proved effective in the healing process, with high satisfaction of clinicians and patients.

This represents for sure a fundamental alternative to the various methods described in literature.