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Year : 2017  |  Volume : 4  |  Issue : 3  |  Page : 117-123

Does combined general–epidural anesthesia reduce the risk for surgical site infections in radical cystectomy?

Department of Anaesthesiology, Ain Shams University, Cairo, Egypt

Correspondence Address:
Hoda Shokri
Department of Anaesthesiology, Ain Shams University, Cairo, 11772
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/roaic.roaic_72_16

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Background Radical cystectomy is an aggressive surgical procedure associated with the highest morbidity and mortality of all commonly performed urological procedures. It has been assumed that regional anesthesia may reduce infectious complications. Objective This aim of this study was to compare whether general anesthesia (GA) combined with epidural anesthesia reduces the incidence of superficial and deep surgical site infections, chest infection, mortality rate, and length of hospital stay. Patients and methods In this prospective randomized parallel group study, 150 patients between 50 and 65 years of age who were scheduled for elective radical cystectomy were randomly divided into two groups: the GA-only group (n=75), which received GA-alone, and the Epi–GA group (n=75), which received both GA and epidural anesthesia. Demographic and clinical data, such as age, sex, and BMI, and surgical data, such as duration of surgical procedure and number of whole blood units given, were recorded. Postoperative data such as superficial and deep surgical site infections, chest infection diagnosed by the consultant over 10 days’ duration, mortality rate, and duration of hospital stay were recorded. Results Demographic, clinical, and surgical data were similar among the study groups. There was no significant difference between the study groups as regards the incidence of superficial and deep surgical site infections, chest infection, and mortality rate. The duration of hospital stay was significantly shorter in the Epi–GA group compared with the GA-only group. Conclusion Our study showed that combined GA and epidural anesthesia offers no advantage over GA alone with regard to the incidence of infectious complications within 10 days postoperatively, but it significantly reduced the length of hospital stay.

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