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February 1993

Effect of Combined Prednisolone, Epidural Analgesia, and Indomethacin on the Systemic Response After Colonic Surgery

Author Affiliations

Lioydminster, Saskatchewan, Canada

Arch Surg. 1993;128(2):247. doi:10.1001/archsurg.1993.01420140124021

To the Editor.—The article by Schulze et al1 in the March 1992 issue of the Archives raises a number of important questions concerning the reporting of clinical studies of new techniques. As the authors point out in their introduction, whether the benefits of modulating the neurohumeral responses to major surgery (not to be confused with efforts to lessen the surgical insult) outweigh the possible disadvantages remains to be determined. It is accepted that potent pharmacologic agents can alter the responses. Whether this is to the patient's benefit or detriment is not clear from this study. The small size of this study makes meaningful analysis of the data difficult. It is noticeable, however, that of those 11 patients in group 2, two patients developed wound dehiscence. Such a high incidence of a serious complication demands more attention than the authors pay to it. It is suggested that poor surgical

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