Effects of epidural combined with general anesthesia versus general anesthesia on quality of recovery of elderly patients undergoing laparoscopic radical resection of colorectal cancer: A prospective randomized trial

Abstract

Study objectives: The aim of the present study was to assess the quality of recovery from anesthesia on patients subjected to laparoscopic radical resection of colorectal cancer under epidural block combined with general anesthesia or general anesthesia by means of Quality of Recovery-15 (QoR-15) questionnaire.

Design: Prospective randomized trial.

Setting: The setting is at an operating room, a post-anesthesia care unit, and a hospital ward.

Patients: Seventy patients, aging from 65 to 79 years with an American Society of Anesthesiologists physical status II or III, were scheduled to undergo laparoscopic radical resection of colorectal cancer.

Interventions: Epidural block combined with general anesthesia or general anesthesia.

Measurements: The QoR-15 was administered by an investigator blind to group allocation before surgery (T₀), at 24 and 72h after surgery (T₁ and T₂), and on postoperative day 7 (T₃). The quality of recovery, as assessed by the score on the QoR-15, was compared between the groups. Besides, the consumption of anesthetics, respiratory recovery time, response time, extubation time, flatus time, the incidence of nausea or vomiting, the consumption of antiemetic and analgesic agents, and the duration of the hospital stay were also recorded.

Main results: The QoR-15 scores at T₁ and T₂ were significantly higher in the E + G group compared with the G group (P < 0.05). Among the five dimensions of the QoR-15, physiological comfort, physiological independence, pain, and emotional dimension were significantly better at T₁ in the E + G group, and physiological comfort and pain were significantly better at T₂ in the E + G group.

Conclusion: This study demonstrates that epidural block combined with general anesthesia can improve the early recovery of elderly patients after laparoscopic radical resection of colorectal cancer from the perspective of patients.

Keywords: Anesthesia; Colorectal surgery; Epidural; Laparoscopy; Postoperative; QoR-15; Recovery.