Postoperative pain and outcomes using spinal analgesia in hepatobiliary-pancreatic surgery

This is a retrospective analysis of intrathecal analgesia in adult patients who underwent liver and pancreatic resection between January 2010 and June 2021 using a standardized enhanced recovery after surgery protocol. The enhanced recovery after surgery protocol was introduced across all hospitals in January 2010. We will compare patients who received intrathecal morphine only to those patients who received intrathecal morphine in combination with intrathecal clonidine and bupivacaine. Patients who underwent surgery at three university teaching hospitals will be included. Austin Hospital, is a university hospital in Melbourne, Australia with a dedicated high volume hepato-pancreatic-biliary and liver transplant centre. Knox Private and Warringal Private Hospitals are teaching hospitals with expertise in major hepato-pancreatic-biliary surgery. Eligible patients were identified by International Statistical Classification of Diseases (ICD) codes that included the following surgical categories: i.) excision of lesion of liver ii.) segmental resection of liver iii.) lobectomy of liver, iv.) trisegmental resection of liver v.) Whipples procedure vi). Distal pancreatectomy with or without splenectomy vii). Other pancreatic resection (total or central pancreatectomy) Patients will be followed-up until hospital discharge from their index admission. As this is a retrospective study, there is no patient involvement.