Does epidural analgesia modify the risk of complications after gastrectomy?

Abstract

Introduction. The surgical treatment of Gastric Cancer is associated with overall complication rates as high as 50%. The intent of this study was to assess the impact of epidural analgesia (EA) on postoperative complication rates among patients undergoing gastric resections. Materials and methods. Of the 617 gastric cancer patients who between 2002 and 2010 had undergone stomach resection, 246 (39.8%) were administered EA. Groups with and without EA were compared. Results. The general rate of complications was lower in the EA group in the univariable analysis – 38.5% vs. 54.2% (odds ratio [OR]: 0.47, 95% confidence interval [CI]: 0.34–0.66, p < 0.001), intra-abdominal abscess (OR 0,28, 95% CI: 0.14–0.59, p = 0.001), pneumonia (OR 0,39, 95% CI: 0.24–0.63, p < 0.001), temperature > 38°C (OR 0.53, 95% CI: 0.37–0.74, p < 0.001) and re-operation (OR 0.53, 95% CI: 0.28–1.00, p = 0.049). These relationships were confirmed in a multivariable analysis for the general number of complications (OR 0.53, 95% CI: 0.37–0.75, p < 0.001), intra-abdominal abscess (OR 0.36, 95% CI: 0.16–0.77, p = 0.009), temperature > 38°C (OR 0.56, 95% CI: 0.39–0.82, p = 0.009), pneumonia (OR 0.42, 95% CI: 0.25–0.71, p = 0.001). Conclusions. Our findings indicate that postoperative treatment with EA for patients undergoing stomach resection is safe and contributes to a reduction in the number of postoperative complications.