Epidural analgesia diminished pain but did not otherwise improve enhanced recovery after laparoscopic sigmoidectomy: a prospective randomized study |
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Authors: | Pertti Turunen Monika Carpelan-Holmström Pekka Kairaluoma Heidi Wikström Olli Kruuna Pertti Pere Martina Bachmann Seppo Sarna Tom Scheinin |
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Institution: | (1) Department of Gastroenterological and General Surgery, Helsinki University Central Hospital, P.O. Box 900, 00029 Helsinki, Finland;(2) Department of Anaesthesia and Intensive Care Medicine, Helsinki University Central Hospital, P.O. Box 900, 00029 Helsinki, Finland;(3) Department of Public Health, University of Helsinki, Helsinki, Finland |
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Abstract: | Background The primary hypothesis for this study was that epidural analgesia reduces the use of opioids and thus advances bowel function
and oral intake and shortens hospital stay after laparoscopic sigmoidectomy performed according to principles of enhanced
recovery after surgery.
Methods For this study, 60 patients with complicated diverticular disease were randomized to the epidural anesthesia group or the
control group before surgery. Postoperative oxycodone consumption, pain, and recovery parameters were followed for 14 days.
Results The epidural group needed less oxycodone than the control group until 12 h postoperatively. They experienced significantly
less pain related to coughing and motion until postoperative day 2. In the epidural group, fewer patients experienced significant
pain, and the duration of postoperative pain was shorter. Postoperative oral intake, bowel function, hospital stay, and overall
complication rate were similar in the two groups. However, the control group had more postoperative hematomas.
Conclusions Epidural analgesia significantly alleviates pain, reducing the need for opioids during the first 48 h after laparoscopic sigmoidectomy.
However, epidural analgesia does not alter postoperative oral intake, mobilization, or length of hospital stay. |
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Keywords: | Enhanced recovery Epidural analgesia Laparoscopic sigmoidectomy |
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