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Erschienen in: European Surgery 2/2015

01.04.2015 | Main Topic

Effect of perioperative epidural anesthesia in elective laparoscopic colorectal resections

verfasst von: M. Anschütz, J. Drautz, MD R. Kafka-Ritsch

Erschienen in: European Surgery | Ausgabe 2/2015

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Summary

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.
Literatur
2.
Zurück zum Zitat Kehlet H, Wilmore DW. Evidence-based surgical care and the evolution of fast-track surgery. Ann Surg. 2008;248:189–98. CrossRefPubMed Kehlet H, Wilmore DW. Evidence-based surgical care and the evolution of fast-track surgery. Ann Surg. 2008;248:189–98. CrossRefPubMed
3.
Zurück zum Zitat Zingg U, Miskovic D, Hamel CT, Erni L, Oertli D, Metzger U. Influence of thoracic epidural analgesia on postoperative pain relief and ileus after laparoscopic colorectal resection: benefit with epidural analgesia. Surg Endosc. 2009;23(2):276–82. CrossRefPubMed Zingg U, Miskovic D, Hamel CT, Erni L, Oertli D, Metzger U. Influence of thoracic epidural analgesia on postoperative pain relief and ileus after laparoscopic colorectal resection: benefit with epidural analgesia. Surg Endosc. 2009;23(2):276–82. CrossRefPubMed
4.
Zurück zum Zitat Chen WK, Ren L, Wei Y, Zhu DX, Miao CH, Xu JM. General anesthesia combined with epidural anesthesia ameliorates the effect of fast-track surgery by mitigating immunosuppression and facilitating intestinal functional recovery in colon cancer patients. Int J Colorectal Dis. In press 2015. Chen WK, Ren L, Wei Y, Zhu DX, Miao CH, Xu JM. General anesthesia combined with epidural anesthesia ameliorates the effect of fast-track surgery by mitigating immunosuppression and facilitating intestinal functional recovery in colon cancer patients. Int J Colorectal Dis. In press 2015.
5.
Zurück zum Zitat Vlug MS, Bartels SA, Wind J, Ubbink DT, Hollmann MW, Bemelman WA, Collaborative LAFA Study Group. Which fast track elements predict early recovery after colon cancer surgery? Colorectal Dis. 2012;14(8):1001–8. CrossRefPubMed Vlug MS, Bartels SA, Wind J, Ubbink DT, Hollmann MW, Bemelman WA, Collaborative LAFA Study Group. Which fast track elements predict early recovery after colon cancer surgery? Colorectal Dis. 2012;14(8):1001–8. CrossRefPubMed
6.
Zurück zum Zitat Levy BF, Scott MJ, Fawcett W, Fry C, Rockall TA. Randomized clinical trial of epidural, spinal or patient-controlled analgesia for patients undergoing laparoscopic colorectal surgery. Br J Surg. 2011;98(8):1068–78. CrossRefPubMed Levy BF, Scott MJ, Fawcett W, Fry C, Rockall TA. Randomized clinical trial of epidural, spinal or patient-controlled analgesia for patients undergoing laparoscopic colorectal surgery. Br J Surg. 2011;98(8):1068–78. CrossRefPubMed
7.
Zurück zum Zitat van de Velde CJ, et al. Experts reviews of the multidisciplinary consensus conference colon and rectal cancer 2012: science, opinions and experiences from the experts of surgery. Eur J Surg Oncol. 2014;40(4):454–68. van de Velde CJ, et al. Experts reviews of the multidisciplinary consensus conference colon and rectal cancer 2012: science, opinions and experiences from the experts of surgery. Eur J Surg Oncol. 2014;40(4):454–68.
8.
Zurück zum Zitat Liu H, Hu X, Duan X, Wu J. Thoracic epidural analgesia (TEA) vs. patient controlled analgesia (PCA) in laparoscopic colectomy: a meta-analysis. Hepatogastroenterology. 2014;61(133):1213–9. Liu H, Hu X, Duan X, Wu J. Thoracic epidural analgesia (TEA) vs. patient controlled analgesia (PCA) in laparoscopic colectomy: a meta-analysis. Hepatogastroenterology. 2014;61(133):1213–9.
9.
Zurück zum Zitat Wongyingsinn M, Baldini G, Charlebois P, Liberman S, Stein B, Carli F. Intravenous lidocaine versus thoracic epidural analgesia: a randomized controlled trial in patients undergoing laparoscopic colorectal surgery using an enhanced recovery program. Reg Anesth Pain Med. 2011;36(3):241–8. CrossRefPubMed Wongyingsinn M, Baldini G, Charlebois P, Liberman S, Stein B, Carli F. Intravenous lidocaine versus thoracic epidural analgesia: a randomized controlled trial in patients undergoing laparoscopic colorectal surgery using an enhanced recovery program. Reg Anesth Pain Med. 2011;36(3):241–8. CrossRefPubMed
10.
Zurück zum Zitat Hermanides J, Hollmann MW, Stevens MF, Lirk P. Failed epidural: causes and management. Br J Anaesth. 2012;109(2):144–54. CrossRefPubMed Hermanides J, Hollmann MW, Stevens MF, Lirk P. Failed epidural: causes and management. Br J Anaesth. 2012;109(2):144–54. CrossRefPubMed
11.
Zurück zum Zitat Konigsrainer I, Bredanger S, Drewel-Frohnmeyer R, et al. Audit of motor weakness and premature catheter dislodgement after epidural analgesia in major abdominal surgery. Anaesthesia. 2009;64:27–31. CrossRefPubMed Konigsrainer I, Bredanger S, Drewel-Frohnmeyer R, et al. Audit of motor weakness and premature catheter dislodgement after epidural analgesia in major abdominal surgery. Anaesthesia. 2009;64:27–31. CrossRefPubMed
12.
Zurück zum Zitat Khan SA, Khokhar HA, Nasr AR, Carton E, El-Masry S. Effect of epidural analgesia on bowel function in laparoscopic colorectal surgery: a systematic review and meta-analysis. Surg Endosc. 2013;27(7):2581–91. CrossRefPubMed Khan SA, Khokhar HA, Nasr AR, Carton E, El-Masry S. Effect of epidural analgesia on bowel function in laparoscopic colorectal surgery: a systematic review and meta-analysis. Surg Endosc. 2013;27(7):2581–91. CrossRefPubMed
13.
Zurück zum Zitat Hu Y, Craig SJ, Rowlingson JC, Morton SP, Thomas CJ, Persinger MB, Isbell J, Lau CL, Kozower BD. Early removal of urinary catheter after surgery requiring thoracic epidural: a prospective trial. J Cardiothorac Vasc Anesth. 2014;28(5):1302–6. CrossRefPubMed Hu Y, Craig SJ, Rowlingson JC, Morton SP, Thomas CJ, Persinger MB, Isbell J, Lau CL, Kozower BD. Early removal of urinary catheter after surgery requiring thoracic epidural: a prospective trial. J Cardiothorac Vasc Anesth. 2014;28(5):1302–6. CrossRefPubMed
Metadaten
Titel
Effect of perioperative epidural anesthesia in elective laparoscopic colorectal resections
verfasst von
M. Anschütz
J. Drautz
MD R. Kafka-Ritsch
Publikationsdatum
01.04.2015
Verlag
Springer Vienna
Erschienen in
European Surgery / Ausgabe 2/2015
Print ISSN: 1682-8631
Elektronische ISSN: 1682-4016
DOI
https://doi.org/10.1007/s10353-015-0302-3

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