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    Study: While Safe, Epidurals Have No Major Affect on Survival Rate

    By Jennifer Huddleston, staff writer     

    A new study by Canadian researchers confirms that post-operative epidurals are safe but have minimal impact on survival after surgery. [1]

    Researchers led by Dr. Duminda Wijeysundera of the University of Toronto and Toronto General Hospital studied data from approximately 259,000 patients who had undergone high-risk non-cardiac surgery in Ontario, Canada, from April 1994 through March 2004.
    [2]

    “Using an epidural for pain control after a major operation was safe and actually caused a slightly improved survival for patients who received an epidural,” Wijeysundera said.
    [3]

    Twenty-two percent of the patients studied received an epidural between the times they were admitted and discharged from the hospital, clinic or doctor’s office where their procedures were performed.
    [4] Those patients had a slightly lower risk of death after 30 days (1.7 percent) compared with those who did not receive an epidural (2 percent). In other words, 477 patients would have to receive an epidural to prevent one death. Given the 1 million patients who undergo surgery in the U.S. each year, [5] these numbers could indicate a boost in survival.

    “This study provides reassuring information that epidural anesthetic is safe and may slightly increase the chance of surviving a major operation,” Wijeysundera said. “These results may help patients make better informed choices about how they manage their pain after a major operation.”
    [6]

    Epidurals are considered the most effective method for relieving pain after particular surgical procedures, especially those performed on the chest or abdominal cavity.
    [7] Wijeysundera noted that patients who received an epidural after major surgery tended to have less pain as well as a lower risk of pneumonia. [8]

    Insufficient post-operative pain management can increase the length of a patient’s hospital stay and the risks of particular complications, such as pneumonia. After upper abdominal surgery, patients experience pulmonary dysfunction due to pain from breathing, which can increase the risk of pneumonia. A 2003 study on the efficacy of post-operative epidural analgesia led by Dr. Brian M. Block found that epidural anesthesia improved these pulmonary findings, citing increased pain relief as a major factor.
    [9]

    Wijeysundera’s research team noted that epidurals are better at relieving post-surgical pain than intravenous opioid drugs and also decrease surgical stress, thereby possibly benefiting the heart and lungs.
    [10]

    The bottom line? Epidurals are safe and should be used, but not on account of the slight improvement in survival, according to Dr. Zeev N. Kain, chair of the Department of Anesthesiology and Perioperative Care at the University of California, Irvine.
    [11]

    The study’s findings were reported in the Aug. 11 online edition of The Lancet.
    [12]



    [1] “Epidural After Surgery Unlikely to Impact Survival.” MedlinePlus. Aug. 11, 2008.
    [2]  Ibid.
    [3] Reinberg, Steven. “Post-Surgical Epidural May Boost Survival.” U.S. News & World Report. Aug. 12, 2008.
    [4] “Epidural After Surgery Unlikely to Impact Survival.” MedlinePlus. Aug. 11, 2008.
    [5] Reinberg, Steven. “Post-Surgical Epidural May Boost Survival.” U.S. News & World Report. Aug. 12, 2008.
    [6]  Ibid.
    [7] “Epidural After Surgery Unlikely to Impact Survival.” MedlinePlus. Aug. 11, 2008.
    [8] Reinberg, Steven. “Post-Surgical Epidural May Boost Survival.” U.S. News & World Report. Aug. 12, 2008.
    [9] Block, Brian M. “Post-Operative Pain Management: The Option of Epidural Analgesia.” Physician’s Weekly. Jan. 12, 2004.
    [10] “Epidural After Surgery Unlikely to Impact Survival.” MedlinePlus. Aug. 11, 2008.
    [11] Reinberg, Steven. “Post-Surgical Epidural May Boost Survival.” U.S. News & World Report. Aug. 12, 2008.
    [12]  Ibid.



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