In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez, is joined by Dr. Sarah Ackroyd to discuss postoperative complications of epidural analgesia. Dr. Sarah Ackroyd is a gynecologic oncology fellow at the University of Chicago. Her research interests include health economics and outcomes research with a focus on decision analysis and patient-centered medical decision making. Dr. Sarah Ackroyd is a gynecologic oncology fellow at the University of Chicago. Her research interests include health economics and outcomes research with a focus on decision analysis and patient-centered medical decision making.

Main points:

- Our study utilizing the NSQIP database found that in a cohort of >2,000 patients who received an epidural at time of hysterectomy for cancer, there was a ~14% higher rate of minor complications including blood transfusions and superficial wound infection.

- Challenges of the epidural including hypotension and related complications, may be explained by the medication-induced sympathetic block that primarily prevents pain perception but can affect other sympathetic functions.J45

- Other studies in Gyn Oncology that utilized the epidural in an ERAS protocol demonstrate an overall improvement in postoperative pain scores, K43decreased opioid use, and no major complications.

- In the appropriate patient with the above findings considered, regional anesthesia such as the epidural, should be considered as part of a multi-modal pain approach.