Short-term outcomes with intrathecal versus epidural analgesia in laparoscopic colorectal surgery

Br J Surg. 2010 Sep;97(9):1401-6. doi: 10.1002/bjs.7127.

Abstract

Background: Epidural analgesia is the mainstay of perioperative pain management in enhanced recovery programmes. This study compared short-term outcomes following epidural or intrathecal analgesia in patients undergoing elective laparoscopic colorectal surgery.

Methods: A single-centre observational study was carried out in 175 consecutive patients who had elective laparoscopic colorectal surgery for benign or malignant disease within an enhanced recovery programme. Seventy-six patients received epidural analgesia and 99 had a single injection of intrathecal analgesia to provide perioperative pain control.

Results: Patients who had intrathecal analgesia had a reduced median postoperative pain score compared with those receiving epidural analgesia (0 versus 3.5; P < 0.001), an earlier return to mobility (1 versus 4 days; P < 0.001) and a shorter hospital stay (4 versus 5 days; P < 0.001). Return to normal gut function and postoperative nausea and vomiting were similar in the two groups.

Conclusion: Intrathecal analgesia may have advantages over epidural analgesia in patients undergoing laparoscopic colorectal surgery.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Analgesia, Epidural / methods*
  • Analgesics, Opioid / administration & dosage*
  • Colonic Diseases / surgery*
  • Female
  • Humans
  • Injections, Spinal
  • Intraoperative Complications / prevention & control
  • Laparoscopy / methods*
  • Male
  • Middle Aged
  • Pain / prevention & control*
  • Postoperative Nausea and Vomiting / etiology
  • Prospective Studies
  • Recovery of Function
  • Rectal Diseases / surgery*
  • Reoperation
  • Treatment Outcome

Substances

  • Analgesics, Opioid