Summary
Background and objective: Epidural analgesia (EA) is a gold-standard in post- operative pain control. Therefore, modern treatment concepts targeting early patient recovery regularly implement EA. Due to its increasing impact, EA should meet high quality standards in respect to application and maintenance. Though, daily practice often reveals EA-related problems, our investigation aimed to improve EA quality by assessing incidence and reasons of undeliberate, premature termina- tion of post-operative EA.
Methods: In the first step all patients with post-operative EA were retrospectively studied covering a 6-month period (group 1). We analysed incidences and reasons of undeliberate termination of EA. Thereafter we modified our treatment proto- cols (preferential thoracic EA, continuous peripheral blocks, low concentrated local anaesthetic solutions, standardized co-medication). This was followed by a prospec- tive analysis of all EA patients for another 6 months (group 2).
Results: 777 patients were included (group 1 n=400, group 2 n=377). Unde- liberate termination of post-operative EA was documented in 24.3% of group 1 patients (group 2: 14.1%; p