Surgical Endoscopy

, Volume 23, Issue 1, pp 31–37

Epidural analgesia diminished pain but did not otherwise improve enhanced recovery after laparoscopic sigmoidectomy: a prospective randomized study

Authors

    • Department of Gastroenterological and General SurgeryHelsinki University Central Hospital
  • Monika Carpelan-Holmström
    • Department of Gastroenterological and General SurgeryHelsinki University Central Hospital
  • Pekka Kairaluoma
    • Department of Anaesthesia and Intensive Care MedicineHelsinki University Central Hospital
  • Heidi Wikström
    • Department of Gastroenterological and General SurgeryHelsinki University Central Hospital
  • Olli Kruuna
    • Department of Gastroenterological and General SurgeryHelsinki University Central Hospital
  • Pertti Pere
    • Department of Anaesthesia and Intensive Care MedicineHelsinki University Central Hospital
  • Martina Bachmann
    • Department of Anaesthesia and Intensive Care MedicineHelsinki University Central Hospital
  • Seppo Sarna
    • Department of Public HealthUniversity of Helsinki
  • Tom Scheinin
    • Department of Gastroenterological and General SurgeryHelsinki University Central Hospital
Article

DOI: 10.1007/s00464-008-0100-0

Cite this article as:
Turunen, P., Carpelan-Holmström, M., Kairaluoma, P. et al. Surg Endosc (2009) 23: 31. doi:10.1007/s00464-008-0100-0

Abstract

Background

The primary hypothesis for this study was that epidural analgesia reduces the use of opioids and thus advances bowel function and oral intake and shortens hospital stay after laparoscopic sigmoidectomy performed according to principles of enhanced recovery after surgery.

Methods

For this study, 60 patients with complicated diverticular disease were randomized to the epidural anesthesia group or the control group before surgery. Postoperative oxycodone consumption, pain, and recovery parameters were followed for 14 days.

Results

The epidural group needed less oxycodone than the control group until 12 h postoperatively. They experienced significantly less pain related to coughing and motion until postoperative day 2. In the epidural group, fewer patients experienced significant pain, and the duration of postoperative pain was shorter. Postoperative oral intake, bowel function, hospital stay, and overall complication rate were similar in the two groups. However, the control group had more postoperative hematomas.

Conclusions

Epidural analgesia significantly alleviates pain, reducing the need for opioids during the first 48 h after laparoscopic sigmoidectomy. However, epidural analgesia does not alter postoperative oral intake, mobilization, or length of hospital stay.

Keywords

Enhanced recoveryEpidural analgesiaLaparoscopic sigmoidectomy

Copyright information

© Springer Science+Business Media, LLC 2008