Use of Epidurals Intraoperatively for Patients Undergoing Pancreas Resection

Randomized Controlled Trial of Epidural-General Anesthesia Versus General Anesthesia for Open Pancreaticoduodenectomy: Influence on Complications and Overall Two Year Survival

The purpose of this study is to see if there is a difference in complications in patients who have an epidural started earlier (during their surgery) and used as part of the anesthetic in addition to using it for post operative pain compared with patients who receive an epidural later in the surgery to be used only for post operative pain.

Inclusion Criteria:

• Adult patients ≥ 18 years of age who can provide informed consent
• Scheduled for pancreaticoduodenectomy

Exclusion Criteria:

• Pregnancy
• History of documented anaphylaxis or contraindication to any of the study medications
• Significant cognitive impairment or documented psychologic impairment
• Contraindication to epidural per Pain Service guidelines
• Use of a sustained release opioid medication such as long-acting morphine, fentanyl patches, methadone, and buprenorphine within the last 3 months
• Post randomization exclusion will occur if the patient is found to have unresectable disease at laparotomy and therefore will not have the potential for the same postoperative complications.