Published online Sep 6, 2019. doi: 10.12998/wjcc.v7.i17.2477
Peer-review started: April 8, 2019
First decision: June 28, 2019
Revised: July 23, 2019
Accepted: July 27, 2019
Article in press: July 27, 2019
Published online: September 6, 2019
Epidural analgesia is a well-known technique use in thoracic and abdominal surgery for its benefits in stress response, pulmonary complications. Anesthesiologists are afraid of its use in patients with potentially haemostatics disorders. Liver surgery is an example of them. In literature is well described the use of epidural analgesia in hepatic surgery and others, with different opinions. So that, we wanted to study the behaviour haemostatic profile after a particular etiology of hepatic resection, colon-rectum liver metastases. We think are patients with particular peculiarities in liver function non comparable to others disease, thus the use of epidural analgesia could be safer than in others, with greater benefits than risks.
Patient wellness, patient comfort, patient care, minimize patient stress previous and following days after surgery is one of the goals for all health professionals. So that, in literature is well published the benefits of epidural analgesia in many patients under thoracic or abdominal surgeries. Is for that we started this study, because of the discrepancies existing in use or not use epidural techniques in patients under liver surgery with potentially haemostatic postoperative disorders.
To know the behaviour of haemostatic profile following a colon-rectum metastases liver resection, to considerer if benefits of epidural analgesia are greater than risks.
The research methods (e.g., experiments, data analysis, surveys, and clinical trials) that were adopted to realize the objectives, as well as the characteristics and novelty of these research methods, should be described in detail.
We found in both minor and major hepatic resections, there was oscillation in international normalized ratio (INR) and prothrombin time till 48th postoperative hours. These variations in minor resections were never greater than INR 1.5, instead in major resections existed at 48th postoperative hours haemostatic alteration that turn to normal range before postoperative day 5. We did not use fresh frozen plasma or prothrombin complex to improve the haemostasia prior to remove an epidural catheter.
Haemostatic profile following colon-rectum hepatic metastases resection. Safety use an epidural catheter in patients under colon-rectum liver metastases resection. Benefits of epidural analgesia for patients under colon-rectum metastases liver resections are greater than risks, but if you chose use it, use it with care. Offer to anaesthesiologists another tool in anesthesia and analgesia management in patients with those characteristics.
Never is enough when in terms of health recommendations is worked. More studies are always necessary to improve and certified your studies.