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Chirurgie 6. Mai 2015

Effect of perioperative epidural anesthesia in elective laparoscopic colorectal resections

Background: The role of general anesthesia combined with epidural anesthesia in laparoscopic colorectal surgery is still controversial. In this retrospective study of 84 consecutive patients, the rate of successfully placed epidural catheter and its effect on perioperative pain and outcome are analyzed.

Methods: A total of 84 patients, 36 (43 %) female, with a median (range) age of 64 (19–82) years and a median (range) body mass index of 25 (15–37) kg/m2, were operated; 12 (14 %) procedures were performed via single-incision laparoscopic technique.

Results: The rate of successfully placed epidural anesthesia was 27 % (23), and less postoperative pain (p = 0.04) and need for opioids (p = 0.00) were observed on the day of surgery and first postoperative day. No effect was observed on bowel function, tolerance of solid food, or hospital stay.

Conclusions: In daily surgical laparoscopic practice, the rate of epidural anesthesia is low. Less pain and less need for opioids, but no effect on bowel function or hospital stay, could be demonstrated.

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