Key result
The EPIMENTAL approach, combining segmental spinal and epidural anesthesia, successfully provided adequate sensory block and maintained hemodynamic stability in five patients undergoing major abdominal oncosurgeries.
Why the study?
General anaesthesia is associated with adverse outcomes and deleterious effects on cancer survival, prompting a shift toward regional techniques that may better maintain perioperative physiological function.
Case Report (n=5)
No
The EPIMENTAL approach (combined segmental spinal and epidural anesthesia) may provide adequate surgical block and maintain hemodynamic stability in cancer patients undergoing major abdominal surgeries.
EPIMENTAL anesthesia may be feasible for major abdominal cancer surgery; leaves open need for RCTs before clinical adoption.
The incidence of cancer and need for cancer surgeries has increased in recent times probably due to widespread prevention campaigns and availability of modern diagnostic tools. General anaesthesia is currently the most extensively used technique but is not only associated with many adverse outcomes but also have deleterious effect on cancer survival. With the modernisation of anaesthetic strategy, focus is slowly shifting towards the regional techniques because of potential in maintaining better physiological functions perioperatively. We have phased in a novel technique of regional anaesthesia i.e. the EPIMENTAL approach, and conducted a case series on five cancer patients who underwent major abdominal oncosurgeries, with the hypothesis of maintaining a streamlined level of non-overlapping segment of dermatome block. Introduction of Epimental approach, might pave a newer dimension in the world of regional anaesthesia in terms of maintaining a better haemodynamic profile of the cancer patients.
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Mondal et al. (2023) conducted a case report in Major abdominal oncosurgeries (n=5). EPIMENTAL approach (segmental spinal and epidural anesthesia) was evaluated on Hemodynamic stability and sensory block adequacy. The EPIMENTAL approach, combining segmental spinal and epidural anesthesia, successfully provided adequate sensory block and maintained hemodynamic stability in five patients undergoing major abdominal oncosurgeries.
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