Author/Authors :
Borzellino, Giuseppe Department of Surgery - University Hospital of Verona - Piazzale A. Stefani 1, 37126 Verona - Italy , Kamal Francis, Nader Yeovil District Hospital and University of Bath - District Hospital NHS Foundation Trust - Taunton - UK , Chapuis, Olivier Clinique Chirurgicale Val d’Or - Paris - France , Krastinova, Evguenia Clinical Research Platform - URC-CRC - Saint Antoine Hospital - APHP - Paris - France , Dyevre, Valérie Clinical Research Platform - URC-CRC - Saint Antoine Hospital - APHP - Paris - France , Genna, Michele Department of Surgery - University Hospital of Verona - Piazzale A. Stefani 1, 37126 Verona - Italy
Abstract :
Introduction. Epidural analgesia has been a cornerstone of any ERAS program for open colorectal surgery. With the improvements in anesthetic and analgesic techniques as well as the introduction of the laparoscopy for colorectal resection, the role of epidural analgesia has been questioned. The aim of the review was to assess through a meta-analysis the impact of epidural analgesia
compared to other analgesic techniques for colorectal laparoscopic surgery within an ERAS program. Methods. Literature research
was performed on PubMed, Embase, and the Cochrane Library. All randomised clinical trials that reported data on hospital stay,
postoperative complications, and readmissions rates within an ERAS program with and without an epidural analgesia after a
colorectal laparoscopic resection were included. Results. Five randomised clinical trials were selected and a total of 168 patients
submitted to epidural analgesia were compared to 163 patients treated by an alternative analgesic technique. Pooled data show a
longer hospital stay in the epidural group with a mean difference of 1.07 (95% CI 0.06–2.08) without any significant differences in
postoperative complications and readmissions rates. Conclusion. Epidural analgesia does not seem to offer any additional clinical benefits to patients undergoing laparoscopic colorectal surgery within an ERAS program.
