Epidural anaesthesia and analgesia in hepatic resections

Abstract

Epidural anaesthesia and analgesia are more widely applied in contemporary oncological liver surgery. The study covered 29 patients at a mean age of 58,410,7 years who underwent hepatic resections in 2013-2015. In the patients with a normal coagulation status and preserved haemodynamics, a high epidural block with superficial general inhalation or venous anaesthesia and small dosages of relaxant with endotracheal intubation were applied. Several parameters of the coagulation status such as INR/PТ, platelet count, aPTT, fibrinogen and D-dimer were analyzed. PT shortening, platelet count reduction, a slight fibtinogen diminution and D-dimer elevation were established. These changes were predominantly outlined among the patients with trisegmentectomy and hemihepatectomy until the fifth postoperative day. Pain reduction was achieved in all the patients operated. An individualized application of the epidural anaesthesia and analgesia as well as continuous monitoring of the coagulation status of the patients selected for liver resections.