Thoracic Epidural versus Morphine Patient Controlled Analgesia After Laparoscopic Colectomy
نویسندگان
چکیده
Despite the benefits of the laparoscopic approach to colorectal surgery patients still experience significant levels of pain postoperatively. This study aimed to compare the use of thoracic epidural vs. morphine patient controlled analgesia in the management of pain after laparoscopic colorectal surgery. A retrospective analysis of hospital records was performed for 16 patients undergoing laparoscopic colorectal surgery (8 thoracic epidural, 8 patient controlled analgesia). Visual rating scale pain scores (0 – 10) were significantly lower for patients managed with thoracic epidural in recovery (mean [95% CI] ) (0 vs. 5.3 [3.6-6.9]), at 6 hours (1 [0-2.0] vs. 5.4 [4.2-6.5]), 12 hours (0.4 [0-1.1] vs. 4.4 [3.3-5.4]) and 24 hours (1.3 [0-2.8] vs. 5.9 [4.96.9]). Thoracic epidural offers the optimal analgesia and quality of care to the patient following laparoscopic colectomy.
منابع مشابه
Randomized clinical trial comparing epidural anaesthesia and patient-controlled analgesia after laparoscopic segmental colectomy (Br J Surg 2003; 90: 1195-1199).
BACKGROUND This randomized clinical trial compared the use of thoracic epidural anaesthesia-analgesia (TEA) with morphine patient-controlled analgesia (PCA) for pain relief after laparoscopic colectomy. METHODS Patients scheduled for segmental laparoscopic colectomy were randomized to receive TEA or PCA. Patients in the TEA group received bupivacaine and fentanyl before incision and after sur...
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BACKGROUND Perioperative thoracic epidural analgesia reduces stress response and pain scores and may improve outcome after cardiac surgery. This prospective, randomized trial was designed to compare the effectiveness of patient-controlled thoracic epidural analgesia with patient-controlled analgesia with intravenous morphine on postoperative hospital length of stay and patients' perception of t...
متن کاملA systematic review of postoperative analgesia following laparoscopic colorectal surgery.
OBJECTIVE The use of epidural analgesia is considered fundamental in Enhanced Recovery Protocols. However its value in the perioperative management of laparoscopic colorectal surgical patients is unclear and analgesic regimens vary. The aim of this systematic review was to examine the effects of various analgesic regimes on outcomes following laparoscopic colectomy. METHOD A systematic review...
متن کاملRole of Epidural and Patient-Controlled Analgesia in Site-Specific Laparoscopic Colorectal Surgery
BACKGROUND AND OBJECTIVES Limited data are available comparing epidural and patient-controlled analgesia in site-specific colorectal surgery. The aim of this study was to evaluate 2 modes of analgesia in patients undergoing laparoscopic right colectomy (RC) and low anterior resection (LAR). METHODS Prospectively collected data on 433 patients undergoing laparoscopic or laparoscopic-assisted c...
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BACKGROUND Despite the laparoscopic approach becoming the standard in colorectal surgery, postoperative pain management for minimally invasive surgery is still mainly based on strategies that have been established for open surgical procedures. Patient-controlled epidural and intravenous analgesia are considered standard postoperative analgesia regimens in colorectal surgery. Epidural analgesia ...
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