Journal Title: زمستان 89 Article title: Evaluation of the Effect of Epidural Anesthesia in Thromboembolic Prophylaxis in Plastic Surgery
Article PDF File: Page From: 26 To: 31
Article abstract:
Introduction & Objective: Epidural anesthesia (EA) is known as a prophylaxis of postoperative thromboembolism, but the mechanisms are poorly understood. Reviewing the literature, we found no reports about the ability of epidural anesthesia to reduce the risk of venous thromboembolism in abdominal contouring surgery and liposuction. The majority of medical publications in this field are derived from orthopedic cases.
Materials & Methods: From June 1992 to August 1995, 27 cases of abdominoplasty and 12 cases of liposuction of lower extremities and abdomen were done under GA (Group1) and from September 1995-August 2009 about 379 cases of abdominoplasty-liposuctioning and 204 lipoaspiration of lower extremities and abdomen were done under EA (Group2) by the 1st author (FH). Thirty two cases (5.5%) of the group 2 transferred to the group 1 due to unsuccessful epidural anesthesia. To have an analysis of the data of this study descriptive statistical methods were used and to compare thromboembolic events and similar distribution of gender in the two groups, fisher test was used.
Results: Two cases (5.5%) of thromboembolic events happened in the group1 (1 case of lower leg venous thrombosis and 1 case of pulmonary embolism). Excluding the patients with medical problems who needed chemical prophylaxis and cases of epidural anesthesia failure from this study, no cases of deep venous thrombosis or pulmonary embolism were detected in the group2 patients.
Conclusions: Employing the differential epidural nerve block mechanism and moving lower limb muscles during the operation is the most effective way to prevent deep venous thrombosis and resultant pulmonary embolism.
