Key result
Perioperative epidural analgesia for laparoscopic or robotic rectal surgery was associated with a significant 25 mg reduction in 72-hour postoperative morphine consumption compared to intravenous analgesia, while achieving comparable pain scores.
Why the study?
Although epidural analgesia is recommended for laparotomic rectal surgery, there is no consensus regarding pain management in laparoscopic or robotic rectal cancer surgery.
Cohort (n=151)
No
May support epidural for opioid sparing in rectal surgery; observational data leave open need for RCTs before practice change.
Although epidural analgesia (EA) is recommended for laparotomic (LT) rectal surgery, there is no consensus regarding pain management in laparoscopic or robotic (LR) rectal cancer surgery. According to our local guidelines, EA is usually chosen for LT rectal procedures and intravenous analgesia for LR rectal procedures.
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Xiao et al. (2022) conducted a cohort in Rectal cancer (n=151). Epidural analgesia vs. Intravenous analgesia (continuous lidocaine) was evaluated on 72-hour total morphine consumption (MD 25.0, 95% CI 2.11-47.9, p=0.01). Perioperative epidural analgesia for laparoscopic or robotic rectal surgery was associated with a significant 25 mg reduction in 72-hour postoperative morphine consumption compared to intravenous analgesia, while achieving comparable pain scores.
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