Role of Epidural Analgesia within an ERAS Program after Laparoscopic Colorectal Surgery: A Review and Meta-Analysis of Randomised Controlled Studies

Surgery Research and Practice Pub Date : 2016-08-24 DOI:10.1155/2016/7543684

G. Borzellino, N. Francis, O. Chapuis, E. Krastinova, V. Dyevre, M. Genna

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引用次数: 66

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.

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腹腔镜结直肠手术后硬膜外镇痛在ERAS中的作用:随机对照研究综述和荟萃分析

介绍。硬膜外镇痛一直是任何直肠直视手术ERAS项目的基石。随着麻醉和镇痛技术的进步以及腹腔镜在结直肠切除术中的应用，硬膜外镇痛的作用受到了质疑。本综述的目的是通过荟萃分析评估硬膜外镇痛与其他镇痛技术在ERAS项目中对结直肠腹腔镜手术的影响。方法。文献研究在PubMed, Embase和Cochrane图书馆进行。所有随机临床试验报告了在ERAS项目中有无硬膜外镇痛的结直肠癌腹腔镜切除术后住院时间、术后并发症和再入院率数据。结果。我们选择了5个随机临床试验，共168例接受硬膜外镇痛的患者与163例采用替代镇痛技术的患者进行了比较。汇总数据显示，硬膜外组住院时间较长，平均差异为1.07 (95% CI 0.06-2.08)，术后并发症和再入院率无显著差异。结论。硬膜外镇痛似乎并没有提供任何额外的临床效益患者接受腹腔镜结肠直肠手术在ERAS计划。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgery Research and Practice

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期刊介绍： Surgery Research and Practice is a peer-reviewed, Open Access journal that provides a forum for surgeons and the surgical research community. The journal publishes original research articles, review articles, and clinical studies focusing on clinical and laboratory research relevant to surgical practice and teaching, with an emphasis on findings directly affecting surgical management.