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Role of epidural and patient-controlled analgesia in site-specific laparoscopic colorectal surgery.
Kaminski, Jan P; Pai, Ajit; Ailabouni, Luay; Park, John J; Marecik, Slawomir J; Prasad, Leela M; Abcarian, Herand.
Afiliación
  • Kaminski JP; Department of Surgery, University of Illinois Metropolitan Group Hospitals, Chicago, Illinois.
  • Pai A; Division of Colon and Rectal Surgery, Advocate Lutheran General Hospital, Park Ridge, Illinois.
  • Ailabouni L; Division of Colon and Rectal Surgery, Advocate Lutheran General Hospital, Park Ridge, Illinois.
  • Park JJ; Division of Colon and Rectal Surgery, Advocate Lutheran General Hospital, Park Ridge, Illinois.
  • Marecik SJ; Division of Colon and Rectal Surgery, Advocate Lutheran General Hospital, Park Ridge, Illinois.
  • Prasad LM; Division of Colon and Rectal Surgery, Advocate Lutheran General Hospital, Park Ridge, Illinois.
  • Abcarian H; Division of Colon and Rectal Surgery, John H. Stroger Hospital of Cook County, Chicago, Illinois.
JSLS ; 18(4)2014.
Article en En | MEDLINE | ID: mdl-25419110
BACKGROUND AND OBJECTIVES: Limited data are available comparing epidural and patient-controlled analgesia in site-specific colorectal surgery. The aim of this study was to evaluate 2 modes of analgesia in patients undergoing laparoscopic right colectomy (RC) and low anterior resection (LAR). METHODS: Prospectively collected data on 433 patients undergoing laparoscopic or laparoscopic-assisted colon surgery at a single institution were retrospectively reviewed from March 2004 to February 2009. Patients were divided into groups undergoing RC (n = 175) and LAR (n = 258). These groups were evaluated by use of analgesia: epidural analgesia, "patient-controlled analgesia" alone, and a combination of both. Demographic and perioperative outcomes were compared. RESULTS: Epidural analgesia was associated with a faster return of bowel function, by 1 day (P < .001), in patients who underwent LAR but not in the RC group. Delayed return of bowel function was associated with increased operative time in the LAR group (P = .05), patients with diabetes who underwent RC (P = .037), and patients after RC with combined analgesia (P = .011). Mean visual analogue scale pain scores were significantly lower with epidural analgesia compared with patient-controlled analgesia in both LAR and RC groups (P < .001). CONCLUSION: Epidural analgesia was associated with a faster return of bowel function in the laparoscopic LAR group but not the RC group. Epidural analgesia was superior to patient-controlled analgesia in controlling postoperative pain but was inadequate in 28% of patients and needed the addition of patient-controlled analgesia.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Dolor Postoperatorio / Analgesia Epidural / Analgesia Controlada por el Paciente / Laparoscopía / Cirugía Colorrectal Límite: Female / Humans / Male / Middle aged Idioma: En Revista: JSLS Año: 2014 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Dolor Postoperatorio / Analgesia Epidural / Analgesia Controlada por el Paciente / Laparoscopía / Cirugía Colorrectal Límite: Female / Humans / Male / Middle aged Idioma: En Revista: JSLS Año: 2014 Tipo del documento: Article Pais de publicación: Estados Unidos