This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Meta‐analysis of epidural analgesia versus parenteral opioid analgesia after colorectal surgery. BJS 2007; 94: 665-673.
Published: 18th May 2007
Authors: E. Marret, C. Remy, F. Bonnet
Background
Epidural analgesia (EA) with local anaesthetic is considered to play a key role after colorectal surgery. However, its effect on postoperative recovery is still a matter of debate.
Method
A systematic review of randomized controlled trials comparing postoperative EA and parenteral opioid analgesia after colorectal surgery was performed. The effect on postoperative recovery was evaluated in terms of length of hospital stay, pain intensity, duration of postoperative ileus, incidence of postoperative complications and side‐effects.
Results
Sixteen trials published between 1987 and 2005 were included. EA significantly reduced pain scores and duration of ileus (weighted mean difference − 1·55 (95 per cent confidence interval (c.i.) − 2·27 to − 0·84) days). On the other hand, it was associated with a significant increase in the incidence of pruritus (odds ratio (OR) 4·8 (95 per cent c.i. 1·3 to 17·0)), urinary retention (OR 4·3 (1·2 to 15·9)) and arterial hypotension (OR 13·5 (4·0 to 57·7)). EA did not influence duration of hospital stay.
Conclusion
Despite improved analgesia and a decrease in ileus, EA has some adverse effects and does not shorten the duration of hospital stay after colorectal surgery. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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