Epidural analgesia diminished pain but did not otherwise improve enhanced recovery after laparoscopic sigmoidectomy: a prospective randomized study.
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.
Turunen
Pertti
P
Department of Gastroenterological and General Surgery, Helsinki University Central Hospital, P.O. Box 900, 00029, Helsinki, Finland. pertti.turunen@hus.fi
Carpelan-Holmström
Monika
M
Kairaluoma
Pekka
P
Wikström
Heidi
H
Kruuna
Olli
O
Pere
Pertti
P
Bachmann
Martina
M
Sarna
Seppo
S
Scheinin
Tom
T
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
D000701:Analgesics, Opioid; D010098:Oxycodone