title: Epidural analgesia diminished pain but did not otherwise improve enhanced recovery after laparoscopic sigmoidectomy: a prospective randomized study.
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.
authors.affiliation: Department of Gastroenterological and General Surgery, Helsinki University Central Hospital, P.O. Box 900, 00029, Helsinki, Finland. pertti.turunen@hus.fi
authors.forename: Pertti
authors.initials: P
authors.lastname: Turunen
authors.forename: Monika
authors.initials: M
authors.lastname: Carpelan-Holmström
authors.forename: Pekka
authors.initials: P
authors.lastname: Kairaluoma
authors.forename: Heidi
authors.initials: H
authors.lastname: Wikström
authors.forename: Olli
authors.initials: O
authors.lastname: Kruuna
authors.forename: Pertti
authors.initials: P
authors.lastname: Pere
authors.forename: Martina
authors.initials: M
authors.lastname: Bachmann
authors.forename: Seppo
authors.initials: S
authors.lastname: Sarna
authors.forename: Tom
authors.initials: T
authors.lastname: Scheinin
mesh_terms: D000328:Adult; D000368:Aged; D015360:Analgesia, Epidural; D000701:Analgesics, Opioid / Q000627:therapeutic use; D003082:Colectomy / Q000009:adverse effects*; D012809:Colon, Sigmoid; D004241:Diverticulum, Colon / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010098:Oxycodone / Q000627:therapeutic use; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D020127:Recovery of Function
chemical_list: D000701:Analgesics, Opioid; D010098:Oxycodone