Effects of thoracic epidural analgesia on postoperative pulmonary complications aftermajor abdominal surgery

The incidence of postoperative pulmonary complications (PPC) has been reported to be 5-40% following major abdominal surgery. Thoracic epidural analgesia (TEA) reduces PPC. The aim of this study was to determine the incidence of PPC and to assess the effect of TEA on PPC in patients who underwent major abdominal surgery in a tertiary university hospital. The files of patients who underwent major abdominal surgery between January 2016 and December 2017 were reviewed retrospectively. The patients were divided into general anesthesia (group 1) and general anesthesia with TEA (group 2) groups. Patient demographic data, smoking history, COPD (Chronic obstructive pulmonary disease) history, diagnosis, surgical process, type of surgery (open / laparoscopic), duration of surgery and PPC at 7 days were recorded. A total of 52 patients’ records were reviewed. PPC occurred in 11 patients in group 1 and in 5 patients in group 2. There was no statistically significant difference between groups in terms of PPC (p = 0.496). The most common PPC was atelectasis (Group 1: 7,Group 2: 5). Weak correlation was found between development of PPC and duration of surgery (r: 0,391, p = 0.004). We found 30% incidence of PPC in our institution in this study. We could not demonstrate a significant reduction in the incidence of PPC with TEA.

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