{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:02:55Z","timestamp":1792098175776,"version":"4.4.0"},"reference-count":45,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2014,3,10]],"date-time":"2014-03-10T00:00:00Z","timestamp":1394409600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["British Journal of Pain"],"published-print":{"date-parts":[[2015,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Epidural analgesia has been the reference standard for the provision of post-operative pain relief in patients recovering from major upper abdominal operations, including liver resections. However, a failure rate of 20\u201332% has been reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>The aim of the study was to analyse the success rates of epidural analgesia and the outcome in patients who underwent liver surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We collected data from a prospectively maintained database of 70 patients who underwent open liver surgery by a bilateral subcostal incision during a period of 20 months (February 2009 to September 2010). Anaesthetic consultants with expertise in anaesthesia for liver surgery performed the epidural catheter placement. A dedicated pain team assessed the post-operative pain scores on moving or coughing using the Verbal Descriptor Scale. The outcome was measured in terms of epidural success rates, pain scores, post-operative chest infection and length of hospital stay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The study group included 43 males and 27 females. The indication for resection was liver secondaries (70%), primary tumours (19%) and benign disease (11%). While major (\u22653 segments) and minor resections (\u2264 2 segments) were performed in 44% and 47% respectively, 9% of patients were inoperable. Epidural analgesia was successful in 64 patients (91%). Bacterial colonisation of epidural tip was noticed in two patients. However, no neurological complications were encountered. Five patients (7%) had radiologically confirmed chest infection. Four patients (6%) developed wound infection. One patient died due to liver failure following extended right hepatectomy and cholecystectomy for gall bladder cancer. The median length of stay was 6 days (3\u201327 days). The extent of liver resection (p = 0.026) and post-operative chest infection (p = 0.012) had a significant influence on the length of stay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Our experience shows that epidural analgesia is safe and effective in providing adequate pain relief following open liver surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/2049463714525140","type":"journal-article","created":{"date-parts":[[2014,3,10]],"date-time":"2014-03-10T22:28:20Z","timestamp":1394490500000},"page":"78-85","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":24,"title":["Epidural analgesia provides effective pain relief in patients undergoing open liver surgery"],"prefix":"10.1177","volume":"9","author":[{"given":"Senthil","family":"Ganapathi","sequence":"first","affiliation":[{"name":"Cardiff Liver Unit, University Hospital of Wales, Cardiff, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gemma","family":"Roberts","sequence":"additional","affiliation":[{"name":"Acute Pain Service, University Hospital of Wales, Cardiff, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Mogford","sequence":"additional","affiliation":[{"name":"Acute Pain Service, University Hospital of Wales, Cardiff, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Bahlmann","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, University Hospital of Wales, Cardiff, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bazil","family":"Ateleanu","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, University Hospital of 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