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Article: Postoperative analgesia reduces mortality and morbidity after esophagectomy

TitlePostoperative analgesia reduces mortality and morbidity after esophagectomy
Authors
Issue Date1997
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/amjsurg
Citation
American Journal Of Surgery, 1997, v. 173 n. 6, p. 472-478 How to Cite?
AbstractBACKGROUND: To study the influence of postoperative analgesia on morbidity and mortality after esophagectomy. METHODS: The outcomes of 578 patients who underwent one-stage resection between 1986 and 1995 were analyzed. Patients who received either epidural morphine, patient-controlled analgesia, or continuous intravenous morphine infusion supervised by an anesthesiology-based acute pain service (group APS, n = 299) were compared with those for whom conventional intramuscular meperidine injections were used (group CON, n = 279). RESULTS: For patients who underwent transthoracic esophagectomy, group APS (n = 226) had a lower incidence of pulmonary complications (13% versus 25%, P = 0.002), cardiovascular complications (21% versus 43%, P < 0.001), and hospital mortality (6% versus 14%, P = 0.038) when compared with group CON (n = 189). No similar difference was demonstrated in patients who underwent esophagectomy without thoracotomy. The hospital stay (days) was shorter in group APS than in group CON for both transthoracic esophagectomy (22 ± 20 versus 30 ± 37, P = 0.005) and nontransthoracic esophagectomy patients (19 ± 13 versus 25 ± 21, P = 0.029). CONCLUSION: Adequate postoperative analgesia is associated with lower cardiopulmonary complications, lower mortality and reduced cost in patients undergoing transthoracic esophagectomy.
Persistent Identifierhttp://hdl.handle.net/10722/84095
ISSN
2015 Impact Factor: 2.403
2015 SCImago Journal Rankings: 1.286
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorTsui, SLen_HK
dc.contributor.authorLaw, Sen_HK
dc.contributor.authorFok, Men_HK
dc.contributor.authorLo, JRen_HK
dc.contributor.authorHo, Een_HK
dc.contributor.authorYang, Jen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2010-09-06T08:48:53Z-
dc.date.available2010-09-06T08:48:53Z-
dc.date.issued1997en_HK
dc.identifier.citationAmerican Journal Of Surgery, 1997, v. 173 n. 6, p. 472-478en_HK
dc.identifier.issn0002-9610en_HK
dc.identifier.urihttp://hdl.handle.net/10722/84095-
dc.description.abstractBACKGROUND: To study the influence of postoperative analgesia on morbidity and mortality after esophagectomy. METHODS: The outcomes of 578 patients who underwent one-stage resection between 1986 and 1995 were analyzed. Patients who received either epidural morphine, patient-controlled analgesia, or continuous intravenous morphine infusion supervised by an anesthesiology-based acute pain service (group APS, n = 299) were compared with those for whom conventional intramuscular meperidine injections were used (group CON, n = 279). RESULTS: For patients who underwent transthoracic esophagectomy, group APS (n = 226) had a lower incidence of pulmonary complications (13% versus 25%, P = 0.002), cardiovascular complications (21% versus 43%, P < 0.001), and hospital mortality (6% versus 14%, P = 0.038) when compared with group CON (n = 189). No similar difference was demonstrated in patients who underwent esophagectomy without thoracotomy. The hospital stay (days) was shorter in group APS than in group CON for both transthoracic esophagectomy (22 ± 20 versus 30 ± 37, P = 0.005) and nontransthoracic esophagectomy patients (19 ± 13 versus 25 ± 21, P = 0.029). CONCLUSION: Adequate postoperative analgesia is associated with lower cardiopulmonary complications, lower mortality and reduced cost in patients undergoing transthoracic esophagectomy.en_HK
dc.languageengen_HK
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/amjsurgen_HK
dc.relation.ispartofAmerican Journal of Surgeryen_HK
dc.rightsThe American Journal of Surgery. Copyright © Elsevier Inc.en_HK
dc.subject.meshAnalgesia - methodsen_HK
dc.subject.meshAnalgesia, Patient-Controlleden_HK
dc.subject.meshEsophagectomy - adverse effects - mortalityen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHeart Diseases - etiologyen_HK
dc.subject.meshHumansen_HK
dc.subject.meshInjections, Intravenousen_HK
dc.subject.meshLength of Stayen_HK
dc.subject.meshLung Diseases - etiologyen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMeperidine - administration & dosageen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshMorphine - administration & dosageen_HK
dc.subject.meshPostoperative Careen_HK
dc.subject.meshTreatment Outcomeen_HK
dc.titlePostoperative analgesia reduces mortality and morbidity after esophagectomyen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0002-9610&volume=173&spage=472&epage=478&date=1997&atitle=Postoperative+analgesia+reduces+mortality+and+morbidity+after+esophagectomyen_HK
dc.identifier.emailLaw, S: slaw@hku.hken_HK
dc.identifier.emailLo, JR: drjohnlo@hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityLaw, S=rp00437en_HK
dc.identifier.authorityLo, JR=rp00041en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/S0002-9610(97)00014-7en_HK
dc.identifier.pmid9207157-
dc.identifier.scopuseid_2-s2.0-0011331320en_HK
dc.identifier.hkuros32369en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0011331320&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume173en_HK
dc.identifier.issue6en_HK
dc.identifier.spage472en_HK
dc.identifier.epage478en_HK
dc.identifier.isiWOS:A1997XG21800004-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridTsui, SL=7004961361en_HK
dc.identifier.scopusauthoridLaw, S=7202241293en_HK
dc.identifier.scopusauthoridFok, M=7005879262en_HK
dc.identifier.scopusauthoridLo, JR=7201650902en_HK
dc.identifier.scopusauthoridHo, E=7102724510en_HK
dc.identifier.scopusauthoridYang, J=26631359500en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK

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