Thoracic Epidural Versus Intravenous Patient-Controlled Analgesia after Open Colorectal Cancer Surgery.

Acta clinica Croatica
Dragana RadovanovićTatjana Ivković-Kapicl

Abstract

The aim of the study was to compare thoracic epidural analgesia (TEA) and intravenous patient-controlled analgesia (IV-PCA) after open colorectal cancer surgery. This prospective study included sixty patients scheduled for elective open colorectal surgery and randomized to either postoperative IV-PCA with morphine (n=30) or TEA with a mixture of levobupivacaine, fentanyl and adrenaline (n=30). Th e primary outcome was return of bowel function. The secondary outcome was quality of postoperative analgesia at rest, on coughing and during mobilization. Intermediate outcomes included patient satisfaction, time out of bed, rate of side effects and postoperative complications, and time of discharge. Recovery of postoperative ileus occurred sooner (p<0.001) and resumption of dietary intake was achieved earlier (p<0.001) in TEA group. Intensity of pain during the first 3 postoperative days was significantly lower at rest, on coughing and during mobilization (p<0.001), and mobilization was much more effi cient (p<0.005) in TEA than in IV-PCA group. Satisfaction scores were better in TEA group (p<0.001). Nausea, sedation and postoperative delirium occurred less frequently in TEA group (p<0.05, p<0.001 and p<0.05, respectively). TEA demons...Continue Reading

Citations

Jul 12, 2018·Current Opinion in Anaesthesiology·Raphael Weiss, Daniel M Pöpping
May 30, 2020·Anesthesia and Analgesia·Tong J GanBeverly K Philip
Jul 10, 2021·Clinical Nutrition : Official Journal of the European Society of Parenteral and Enteral Nutrition·James AshcroftRichard Justin Davies
Jul 22, 2021·Anesthesia and Pain Medicine·Jong-Hyuk LeeWon Uk Koh
Nov 6, 2021·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Ryan HowleNeel Desai

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