Ileus Clinical Trial
Official title:
Effect of Thoracic Epidural Analgesia on Bowel Function Recovery in Major Upper Abdominal Surgeries
The investigators try to find whether thoracic epidural analgesia (TEA) shortens the first gas-out time compared to iv-PCA and promotes earlier discharge after major upper abdominal surgery.
Postoperative ileus (POI) is a prolonged inhibition of coordinated bowel activity after
surgery. Half of patients undergoing major abdominal surgery experience POI making it one of
the limiting factors for early recovery.
The pathogenesis of POI is multifactorial, and includes neurogenic, inflammatory and
pharmacological mechanisms. Thoracic epidural analgesia (TEA) can induce sympathetic block,
attenuate inflammatory reaction and limit use of systemic opioids. In addition,
sympatholysis induced by TEA can improve microcirculation of bowels and parasympathetic
activation can increase gastrointestinal motility.
However, studies comparing TEA and iv-PCA on POI are rare in major upper abdominal
surgeries. This study, therefore, compares TEA and iv-PCA in terms of bowel function
recovery as a primary endpoint in major upper abdominal surgeries. Secondary endpoints are
side effects and hospital stay.
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Allocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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