Effect of epidural analgesia on bowel function in laparoscopic colorectal surgery: a systematic review and meta-analysis

Abstract

Despite of some beneficial effect of epidural analgesia on return of bowel function and pain in laparoscopic surgery, it does not affect LOS, which is multifactorial.

Fast-track surgery versus traditional perioperative care in laparoscopic colorectal cancer surgery: a meta-analysis

“…On one hand, six studies used epidural analgesia, which showed wide acceptance. The beneficial effect of epidural analgesia in pain control has also been confirmed by many studies [40, 41]. On the other hand, epidural analgesia during laparoscopic surgery is not advocated by some authors.…”

“…The meta-analysis conducted by Levy et al [40] suggested that no analgesia protocol showed more overall benefits than did other protocols during laparoscopic surgery. Another meta-analysis showed that epidural analgesia fails to shorten the hospital stay following laparoscopic colorectal surgery [41]. Moreover, even Kehlet [2], who initiated FTS, demonstrated that epidural analgesia might not be necessary in laparoscopic colorectal surgery and can be replaced by non-opioid analgesia.…”

Optimizing pain management to facilitate Enhanced Recovery After Surgery pathways

“…16,17 A multimodal epidural infusion comprising drugs with different pharmacological pathways is more effective than a single-agent infusion. The combination of local anesthetics and adjuvants provides both intraoperative and postoperative analgesia after a wide range of surgeries (e.g., thoracic, abdominal, lower limb).…”

Systemic lidocaine in surgical procedures

“…lidocaine with epidural bupivacaine in relation to resumption of bowel motility. The authors found no differences with respect to the start of bowel movements and concluded that the favorable effects of this type demonstrated for epidural analgesia [22] can also be achieved with i.v. lidocaine.…”