Effects of lumbar epidural analgesia and general anaesthesia on flow velocity in the femoral vein and postoperative deep vein thrombosis. 1983

E Poikolainen, and H Hendolin

The effect of lumbar epidural analgesia and of general anaesthesia on the peroperative velocity of flow in the femoral vein was measured with Doppler ultrasound technique in 38 patients undergoing retropubic prostatectomy. The patients were randomly allocated to the epidural or the general procedure. The 125I-fibrinogen test was used to detect deep vein thrombosis (DVT). Epidural analgesia was associated with a significant (ca. 120%) increase in the femoral venous flow velocity. The peak flow showed a moderate (47%) increase, whereas the minimum flow was greatly increased (188%). The increase was significant already 2 min after induction of the analgesia and the rate continued to rise for about 11 min. General anaesthesia significantly reduced the flow velocity in the femoral vein. Immediately after induction of the anaesthesia the velocity approached zero, but gradually rose, and after about 8 min was stabilized at level 40% below the preoperative velocity. The peak flow velocity in all patients of this group fell by 24 to 40%. Only 2 of 17 patients with epidural analgesia, but 11 of 21 with general anaesthesia had postoperative DVT. In the 11 patients with DVT the mean minimum velocity of flow was decreased (by 85%), but in the 10 without DVT it was increased (by 175%). The difference was not statistically significant. Increased velocity of flow in the femoral vein, especially of minimum flow, seems to counteract development of DVT.

UI MeSH Term Description Entries
D008297 Male Males
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D011468 Prostatectomy Complete or partial surgical removal of the prostate. Three primary approaches are commonly employed: suprapubic - removal through an incision above the pubis and through the urinary bladder; retropubic - as for suprapubic but without entering the urinary bladder; and transurethral (TRANSURETHRAL RESECTION OF PROSTATE). Prostatectomy, Retropubic,Prostatectomy, Suprapubic,Prostatectomies,Prostatectomies, Retropubic,Prostatectomies, Suprapubic,Retropubic Prostatectomies,Retropubic Prostatectomy,Suprapubic Prostatectomies,Suprapubic Prostatectomy
D012121 Respiration, Artificial Any method of artificial breathing that employs mechanical or non-mechanical means to force the air into and out of the lungs. Artificial respiration or ventilation is used in individuals who have stopped breathing or have RESPIRATORY INSUFFICIENCY to increase their intake of oxygen (O2) and excretion of carbon dioxide (CO2). Ventilation, Mechanical,Mechanical Ventilation,Artificial Respiration,Artificial Respirations,Mechanical Ventilations,Respirations, Artificial,Ventilations, Mechanical
D001783 Blood Flow Velocity A value equal to the total volume flow divided by the cross-sectional area of the vascular bed. Blood Flow Velocities,Flow Velocities, Blood,Flow Velocity, Blood,Velocities, Blood Flow,Velocity, Blood Flow
D005268 Femoral Vein The vein accompanying the femoral artery in the same sheath; it is a continuation of the popliteal vein and becomes the external iliac vein. Femoral Veins,Vein, Femoral,Veins, Femoral
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000767 Anesthesia, Epidural Procedure in which an anesthetic is injected into the epidural space. Anesthesia, Extradural,Anesthesia, Peridural,Epidural Anesthesia,Anesthesias, Epidural,Anesthesias, Extradural,Anesthesias, Peridural,Epidural Anesthesias,Extradural Anesthesia,Extradural Anesthesias,Peridural Anesthesia,Peridural Anesthesias
D000768 Anesthesia, General Procedure in which patients are induced into an unconscious state through use of various medications so that they do not feel pain during surgery. Anesthesias, General,General Anesthesia,General Anesthesias
D013924 Thrombophlebitis Inflammation of a vein associated with a blood clot (THROMBUS). Phlegmasia Alba Dolens,Dolens, Phlegmasia Alba,Thrombophlebitides

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