Epidural Analgesia for Postoperative Pain Management Is Key in Enhancing Recovery of Colorectal Surgery Patients
(February 20, 2013)
A new study in the March issue of Anesthesiology suggests epidural analgesia (EA) may be a more effective component in the perioperative care of patients undergoing elective open colorectal surgery than the proposed alternative, continuous wound infiltration of local anesthetics (CWI).
Effective postoperative analgesia allowing early mobilization is an essential component of fast-track anesthesia and surgery programs. While EA can provide such effective analgesia after colorectal surgery, CWI has been proposed as an alternative because it could be cheaper and simpler to use.
A team of anesthesiologists from the University Hospital of Clermont-Ferrand in France compared both EA and CWI in a randomized, double blind controlled trial of patients undergoing colorectal surgery. Findings showed EA produced better patient outcomes including an increase in postoperative pain relief, faster functional recovery and shorter hospital stays than CWI.
The study treated fifty patients with either EA or CWI for 48 hours. In both groups, patients were managed according to the Enhanced Recovery After Surgery (ERAS) program, based on the principle that reducing the body’s stress response after surgery reduces the time needed to recuperate. Patients’ pain scores were measured 24 hours after surgery using a 100-mm verbal numerical scale.
“We knew CWI was seen as an attractive solution for pain care in abdominal surgery recovery, but it hadn’t been directly compared to the tried-and-true epidural method for colorectal surgery patients,” said study author Emmanuel Futier, M.D. “Unlike after abdominal surgery, our study found EA was the superior choice after colorectal surgery.”
The findings suggest the added cost and complexity of EA are worth it to provide the best form of pain relief for colorectal surgery patients.
For more information, visit the Anesthesiology website at anesthesiology.org and physician-paincare.com.
THE AMERICAN SOCIETY OF ANESTHESIOLOGISTS
Founded in 1905, the American Society of Anesthesiologists (ASA) is an educational, research and scientific society with more than 50,000 members organized to raise and maintain the standards of the medical practice of anesthesiology. ASA is committed to ensuring that physician anesthesiologists evaluate and supervise the medical care of patients before, during, and after surgery to provide the highest quality and safest care that every patient deserves.
For more information on the field of anesthesiology, visit the American Society of Anesthesiologists online at asahq.org. To learn more about the role physician anesthesiologists play in ensuring patient safety, visit asahq.org/WhenSecondsCount. Join the ANESTHESIOLOGYTM 2013 social conversation today. Like ASA on Facebook, follow ASALifeline on Twitter and use the hashtag #ANES2013.