Enhanced Recovery After Surgery Programs for Laparoscopic Colorectal Resection May Not Need Thoracic Epidural Analgesia.
The aim of this study was to evaluate the necessity of thoracic epidural analgesia (TEA) as enhanced recovery after surgery (ERAS) programs for laparoscopic colorectal surgery (LC).



We retrospectively compared between perioperative outcomes of patients who underwent LC with TEA (n=31) and with multimodal analgesia (MMA) (n=31). Furthermore, we also evaluated the patients' satisfaction by a questionnaire survey to the nurses.



The only numeric rating scale (NRS) score on post-operative day (POD) 1 of the MMA group was significantly higher than that in the TEA group (p=0.002). In multivariate analysis, the factors that demonstrated significant correlation with hospital stay did not include analgesia. The 74% of the nurses felt equal or higher analgesic effect in the MMA group and interestingly, 84% of them answered that they would choose MMA if they were to undergo LC.



TEA may not be necessary for ERAS in LC.
Department of Surgery, Jikei University, School of Medicine, Tokyo, Japan etoken@jikei.ac.jp.
Ken
K
Eto
Department of Anesthesiology, Jikei University, School of Medicine, Tokyo, Japan.
Ichiro
I
Kondo
Department of Surgery, Jikei University, School of Medicine, Tokyo, Japan.
Makoto
M
Kosuge
Department of Surgery, Jikei University, School of Medicine, Tokyo, Japan.
Masahisa
M
Ohkuma
Department of Surgery, Jikei University, School of Medicine, Tokyo, Japan.
Koichiro
K
Haruki
Department of Surgery, Jikei University, School of Medicine, Tokyo, Japan.
Kai
K
Neki
Department of Surgery, Jikei University, School of Medicine, Tokyo, Japan.
Hiroshi
H
Sugano
Department of Surgery, Jikei University, School of Medicine, Tokyo, Japan.
Ryosuke
R
Hashizume
Department of Surgery, Jikei University, School of Medicine, Tokyo, Japan.
Katsuhiko
K
Yanaga
D000368:Aged; D000698:Analgesia; D015360:Analgesia, Epidural; D015179:Colorectal Neoplasms / Q000601:surgery*; D003107:Colorectal Surgery / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D059408:Pain Management; D010147:Pain Measurement; D010149:Postoperative Pain / Q000628:therapy; D017060:Patient Satisfaction; D011184:Postoperative Period; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013904:Thoracic Vertebrae; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
Epidural analgesia; enhanced recovery after surgery; laparoscopic colorectal surgery; multimodal analgesia