{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T12:11:22Z","timestamp":1763035882191},"reference-count":158,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2004,5,21]],"date-time":"2004-05-21T00:00:00Z","timestamp":1085097600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2004,6,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The ideal perioperative analgesia should provide effective pain relief, avoid the detrimental effects of the stress response, be simple to administer without the need for intensive monitoring, and have a low risk of complications.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This review defines the physiological effects of epidural analgesia and assesses whether the available evidence supports its preferential use in gastrointestinal surgery. All papers studied were identified from a Medline search or selected by cross-referencing.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Epidural analgesia is associated with a shorter duration of postoperative ileus, attenuation of the stress response, fewer pulmonary complications, and improved postoperative pain control and recovery. It does not reduce anastomotic leakage, intraoperative blood loss, transfusion requirement, risk of thromboembolism or cardiac morbidity, or hospital stay compared with that after conventional analgesia in unselected patients undergoing gastrointestinal surgery. Thoracic epidural analgesia reduces hospital costs and stay in patients at high risk of cardiac or pulmonary complications.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Epidural analgesia enhances recovery after gastrointestinal surgery. The results support the development of structured regimens of early postoperative feeding and mobilization to exploit the potential for thoracic epidural analgesia to reduce hospital stay after gastrointestinal surgery.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.4607","type":"journal-article","created":{"date-parts":[[2004,5,21]],"date-time":"2004-05-21T17:00:51Z","timestamp":1085158851000},"page":"828-841","source":"Crossref","is-referenced-by-count":113,"title":["Epidural analgesia in gastrointestinal surgery"],"prefix":"10.1093","volume":"91","author":[{"given":"R J","family":"Fotiadis","sequence":"first","affiliation":[{"name":"Division of Surgery, Anaesthetics and Intensive Care, Faculty of Medicine, Imperial College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Badvie","sequence":"additional","affiliation":[{"name":"Division of Surgery, Anaesthetics and Intensive Care, Faculty of Medicine, Imperial College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M D","family":"Weston","sequence":"additional","affiliation":[{"name":"Department of Anaesthetics, Intensive Care and Pain Management, Chelsea and Westminster Healthcare Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T G","family":"Allen-Mersh","sequence":"additional","affiliation":[{"name":"Division of Surgery, Anaesthetics and Intensive Care, Faculty of Medicine, Imperial College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2004,5,21]]},"reference":[{"key":"2021070911532258600_bib1","first-page":"167","article-title":"Anesthesie medullaire chirurgicale par injection sous-arachno lombaire de coca; technique et resultats","volume":"20","author":"Tuffier","year":"1900","journal-title":"La Semaine Medicale"},{"key":"2021070911532258600_bib2","first-page":"501","article-title":"Standardized perioperative care protocols and reduced length of stay after colon surgery","volume":"186","author":"Bradshaw","year":"1998","journal-title":"JAMA"},{"key":"2021070911532258600_bib3","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1046\/j.1365-2168.1999.01023.x","article-title":"Hospital stay of 2 days after open sigmoidectomy with a multinodal rehabilitation programme","volume":"86","author":"Kehlet","year":"1999","journal-title":"Br J Surg"},{"key":"2021070911532258600_bib4","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1136\/bmj.319.7209.530","article-title":"Epidural anaesthesia and analgesia: better outcome after major surgery? 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