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Chirurgie 6. Mai 2015

Is epidural anaesthesia mandatory in fast-track surgery for elective colorectal resections?

Background: Epidural anaesthesia is considered as a basic element of enhanced recovery after surgery (ERAS). In regard of the expenditure and the possible complications, the authors established a modified protocol without epidural analgesia.

Methods: In this prospective single-centre study, 64 consecutive patients undergoing elective colorectal surgery were treated according to the concept of ERAS, replacing epidural analgesia with infiltration of the incision lines.

Results: Adequate pain control was possible in 52 (81 %) patients; 55 (86 %) did not need any antiemetic drugs, 41 (64 %) tolerated solid food on the first postoperative day and 51 (80 %) had first bowel movement until day 2. Discharge was possible on day 4.3, overall complication rate was 19 % and 30-day mortality was 3 %.

Conclusions: ERAS in elective colon surgery is feasible using local infiltration of the incision line resulting in comparable outcome in regard of pain control, intestinal paralysis and complications.

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