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Gastroenterologie 10. November 2015

Pain perception and short-term outcomes in totally laparoscopic colonic surgery with two different fast track programs

Aim of the study: to evaluated pain perception and return to normal daily activities in two groups of patients undergoing elective totally laparoscopic colonic surgery according to two different analgesic protocols within Fast Track programs.

Method: we compared two groups of patients prospectively evaluated in terms of post-operative painperception and short term outcomes undergoing totally laparoscopic elective colonic surgery among fasttrack programs. 46 patients (43 completed the study) (Group 1) received analgesia with spinal injection 30 min before surgery of Morphine 0,2 – 0,3 mg , morphine PCA post operatively, Paracetamol 1 gr if needed every 8 h. 43 patients (40 completed the study) (Group 2) received analgesia with Paracetamol 1 gr every 6 h , ketorolac every 12 h, Lidocaine wound infiltration.

Result: Patients in G2 passed flatus and stool significantly before those in G1 (p<0,05) and were discharged significantly earlier than those in G1 (p<0,05). Return to normal daily activities was similar in the two groups.

Pain perception in the immediate post-operative period was significantly higher in patients in G2 (p<0,05).

Conclusion: Morphine free analgesia significantly improve bowel function recovery and hospitalization. Pain perception in the immediate post-operative needs to be optimized.

G. Mari, P. Martini, D. Maggioni, A. Costanzi, G. Ferrari, S. Carli, R. Pugliese, European Surgery 5/2015

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