Recovery after laparoscopic colonic surgery with epidural analgesia, and early oral nutrition and mobilisation

Lancet. 1995 Mar 25;345(8952):763-4. doi: 10.1016/s0140-6736(95)90643-6.


The rate of postoperative recovery is determined by pain, stress-induced organ dysfunction, and limitations in conventional postoperative care. We attempted to provide "stress-free" colonic resection for neoplastic disease in eight elderly high-risk patients by a combination of laparoscopically assisted surgery, epidural analgesia, and early oral nutrition and mobilisation. Effective pain relief allowed early mobilisation, and hospital stay was reduced to 2 days without nausea, vomiting, or ileus. Postoperative fatigue and impairment in functional activity were avoided. Major advances in postoperative recovery can be achieved by early aggressive perioperative care in elderly high-risk patients undergoing colonic surgery.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma / surgery*
  • Aged
  • Aged, 80 and over
  • Analgesia, Epidural*
  • Anesthesia, General
  • Bupivacaine / administration & dosage*
  • Colonic Neoplasms / surgery*
  • Early Ambulation*
  • Fatigue / etiology
  • Humans
  • Laparoscopy*
  • Nutritional Physiological Phenomena*
  • Pain, Postoperative / drug therapy
  • Postoperative Complications


  • Bupivacaine