THE FEASIBILITY OF EPIDURAL-ANESTHESIA WITHOUT ENDOTRACHEAL INTUBATION FOR ABDOMINAL-SURGERY IN PATIENTS WITH COLLAGEN DISEASES

Background/Aims: Patients with collagen diseases are generally regarde d as high- risk surgical candidates. Material and Methods: To evaluate the feasibility of epidural anesthesia and to determine the risk fact ors in, abdominal surgery for patients with collagen diseases, 20 pati ents with collagen diseases who underwent elective abdominal surgery w ere examined for their surgical outcomes and clinical characteristics. Among the 20 cases, 12 received epidural anesthesia alone without end otracheal intubation, 3 received general anesthesia only, 4 received g eneral anesthesia with epidural anesthesia and one received Lumbar ane sthesia. Results: Only one patient receiving epidural anesthesia died after operation. The mortality in patients receiving epidural anesthes ia was 8.3% (1/12) while the overall mortality was 5.0% (1/20). No sig nificant difference was observed either in, the mortality or incidence of postoperative complications among the 4 groups according to the me thod of anesthesia. Patients with a dysfunction, of the vital organs m ore often had postoperative complications than. those without a dysfun ction of the vital organs (p=0.043). Conclusions: Although only a smal l number of patients were included in this study, these results sugges ted that 1) elective abdominal surgery can be as safely performed unde r epidural anesthesia alone as with general anesthesia even for patien ts with collagen diseases, and 2) the patients with collagen diseases, who preoperatively showed a dysfunction of the vital organs, might be at a higher risk for abdominal surgery.