Does an epidural containing a local anesthetic improve postoperative gastrointestinal transit and pain compared to opioid-based regimens in patients after abdominal surgery?
Epidural local anesthetics accelerate gastrointestinal transit and reduce pain after abdominal surgery compared to opioid-based regimens.
An epidural containing a local anesthetic, with or without the addition of an opioid, accelerates the return of the gastrointestinal transit (high quality of evidence). An epidural containing a local anesthetic with an opioid decreases pain after an abdominal surgery (moderate quality of evidence). An epidural containing a local anesthetic does not affect the incidence of vomiting or anastomotic leak (low quality of evidence). For an open surgery, an epidural containing a local anesthetic would reduce the length of hospital stay (very low quality of evidence).
Guay et al. (2016) studied this question.