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Combined epidural‐general anaesthesia vs general anaesthesia in neonatal gastrointestinal surgery: A randomized controlled trial
Author(s) -
GannamSomri Lina,
Matter Ibrahim,
Hadjittofi Christopher,
Vaida Sonia,
Khalaily Husein,
Hossein Jalaa,
Somri Mostafa
Publication year - 2020
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/aas.13469
Subject(s) - medicine , anesthesia , gastrointestinal function , general anaesthesia , surgery , ileus , randomized controlled trial , complication
Background Post‐operative ileus is a frequent complication of gastrointestinal surgery under general anaesthesia. The aim of this study was to investigate whether combined epidural‐general anaesthesia is associated with expedited gastrointestinal function recovery in neonates undergoing elective gastrointestinal surgery. Methods A randomized controlled trial including 60 neonates who underwent gastrointestinal surgery at a university hospital was performed. Thirty neonates received combined epidural‐general anaesthesia (CEGA), and 30 neonates received general anaesthesia (GA) alone. The primary outcome was the post‐operative time to tolerance of full enteral nutrition. The secondary outcomes were the post‐operative time defaecation, the duration of nasogastric drainage, and infections. Results After excluding two neonates from the CEGA group, where repeated attempts at epidural catheterization were unsuccessful, a total of 58 patients completed the study (CEGA: 28; GA: 30). Full enteral nutrition was tolerated earlier in CEGA vs the GA group (4.0 vs 8.0 days; P = .0001). Time to defaecation was shorter in the CEGA group (3.5 vs 5.0 days; P = .0001). Duration of nasogastric drainage was similar between groups (7.0 vs 7.0 days; P = .9502). Fewer patients in the CEGA group experienced post‐operative infection (35.7% vs 60.0%; P = .038). Conclusion Combined epidural‐general anaesthesia is associated with expedited gastrointestinal function recovery and a lower infection risk after gastrointestinal surgery in neonates.