Randomized clinical trial comparing epidural anaesthesia and patient-controlled analgesia after laparoscopic segmental colectomy

A. J. Senagore, C. P. Delaney, N. Mekhail, A. Dugan, V. W. Fazio

Research output: Contribution to journalArticle

116 Citations (Scopus)

Abstract

Background: This randomized clinical trial compared the use of thoracic epidural anaesthesia-analgesia (TEA) with morphine patient-controlled analgesia (PCA) for pain relief after laparoscopic colectomy. Methods: Patients scheduled for segmental laparoscopic colectomy were randomized to receive TEA or PCA. Patients in the TEA group received bupivacaine and fentanyl before incision and after surgery by continuous infusion for 18 h. Patients in the PCA group self-administered morphine using an intravenous pump. The postoperative care plan was otherwise identical for the two groups. Postoperative pain was measured during ambulation using a visual analogue pain score. Results: The study included 38 patients (18 TEA, 20 PCA), 16 of whom underwent right hemicolectomy or ileocolectomy and 22 sigmoid colectomy. Operating times, patient weight and distribution of American Society of Anesthesiologists grade were similar in the two groups. The mean(s.e.m.) total dose of drugs administered was 64(41) mg morphine in the PCA group, and 79(42) mg bupivacaine and 205(140) μg fentanyl in the TEA group. Postoperative pain scores were significantly better in the TEA group at 6 h (mean(s.e.m.) 2.2(0.4) versus 6.6(0.5) with PCA; P = 0.001) and 18 h (2.2(0.3) versus 4.0(0.4); P = 0.003). Hospital stay was similar in the two groups. Conclusion: TEA significantly improved early analgesia following laparoscopic colectomy but did not affect the length of hospital stay.

Original languageEnglish (US)
Pages (from-to)1195-1199
Number of pages5
JournalBritish Journal of Surgery
Volume90
Issue number10
DOIs
StatePublished - Oct 2003
Externally publishedYes

Fingerprint

Anesthesia and Analgesia
Patient-Controlled Analgesia
Epidural Analgesia
Colectomy
Epidural Anesthesia
Thorax
Randomized Controlled Trials
Morphine
Length of Stay
Bupivacaine
Fentanyl
Postoperative Pain
Pain
Postoperative Care
Sigmoid Colon
Analgesia
Walking
Weights and Measures
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Surgery

Cite this

Randomized clinical trial comparing epidural anaesthesia and patient-controlled analgesia after laparoscopic segmental colectomy. / Senagore, A. J.; Delaney, C. P.; Mekhail, N.; Dugan, A.; Fazio, V. W.

In: British Journal of Surgery, Vol. 90, No. 10, 10.2003, p. 1195-1199.

Research output: Contribution to journalArticle

Senagore, A. J. ; Delaney, C. P. ; Mekhail, N. ; Dugan, A. ; Fazio, V. W. / Randomized clinical trial comparing epidural anaesthesia and patient-controlled analgesia after laparoscopic segmental colectomy. In: British Journal of Surgery. 2003 ; Vol. 90, No. 10. pp. 1195-1199.
@article{2a9dc0e8de98439d92607b25cba87a06,
title = "Randomized clinical trial comparing epidural anaesthesia and patient-controlled analgesia after laparoscopic segmental colectomy",
abstract = "Background: This randomized clinical trial compared the use of thoracic epidural anaesthesia-analgesia (TEA) with morphine patient-controlled analgesia (PCA) for pain relief after laparoscopic colectomy. Methods: Patients scheduled for segmental laparoscopic colectomy were randomized to receive TEA or PCA. Patients in the TEA group received bupivacaine and fentanyl before incision and after surgery by continuous infusion for 18 h. Patients in the PCA group self-administered morphine using an intravenous pump. The postoperative care plan was otherwise identical for the two groups. Postoperative pain was measured during ambulation using a visual analogue pain score. Results: The study included 38 patients (18 TEA, 20 PCA), 16 of whom underwent right hemicolectomy or ileocolectomy and 22 sigmoid colectomy. Operating times, patient weight and distribution of American Society of Anesthesiologists grade were similar in the two groups. The mean(s.e.m.) total dose of drugs administered was 64(41) mg morphine in the PCA group, and 79(42) mg bupivacaine and 205(140) μg fentanyl in the TEA group. Postoperative pain scores were significantly better in the TEA group at 6 h (mean(s.e.m.) 2.2(0.4) versus 6.6(0.5) with PCA; P = 0.001) and 18 h (2.2(0.3) versus 4.0(0.4); P = 0.003). Hospital stay was similar in the two groups. Conclusion: TEA significantly improved early analgesia following laparoscopic colectomy but did not affect the length of hospital stay.",
author = "Senagore, {A. J.} and Delaney, {C. P.} and N. Mekhail and A. Dugan and Fazio, {V. W.}",
year = "2003",
month = "10",
doi = "10.1002/bjs.4223",
language = "English (US)",
volume = "90",
pages = "1195--1199",
journal = "British Journal of Surgery",
issn = "0007-1323",
publisher = "John Wiley and Sons Ltd",
number = "10",

}

TY - JOUR

T1 - Randomized clinical trial comparing epidural anaesthesia and patient-controlled analgesia after laparoscopic segmental colectomy

AU - Senagore, A. J.

AU - Delaney, C. P.

AU - Mekhail, N.

AU - Dugan, A.

AU - Fazio, V. W.

PY - 2003/10

Y1 - 2003/10

N2 - Background: This randomized clinical trial compared the use of thoracic epidural anaesthesia-analgesia (TEA) with morphine patient-controlled analgesia (PCA) for pain relief after laparoscopic colectomy. Methods: Patients scheduled for segmental laparoscopic colectomy were randomized to receive TEA or PCA. Patients in the TEA group received bupivacaine and fentanyl before incision and after surgery by continuous infusion for 18 h. Patients in the PCA group self-administered morphine using an intravenous pump. The postoperative care plan was otherwise identical for the two groups. Postoperative pain was measured during ambulation using a visual analogue pain score. Results: The study included 38 patients (18 TEA, 20 PCA), 16 of whom underwent right hemicolectomy or ileocolectomy and 22 sigmoid colectomy. Operating times, patient weight and distribution of American Society of Anesthesiologists grade were similar in the two groups. The mean(s.e.m.) total dose of drugs administered was 64(41) mg morphine in the PCA group, and 79(42) mg bupivacaine and 205(140) μg fentanyl in the TEA group. Postoperative pain scores were significantly better in the TEA group at 6 h (mean(s.e.m.) 2.2(0.4) versus 6.6(0.5) with PCA; P = 0.001) and 18 h (2.2(0.3) versus 4.0(0.4); P = 0.003). Hospital stay was similar in the two groups. Conclusion: TEA significantly improved early analgesia following laparoscopic colectomy but did not affect the length of hospital stay.

AB - Background: This randomized clinical trial compared the use of thoracic epidural anaesthesia-analgesia (TEA) with morphine patient-controlled analgesia (PCA) for pain relief after laparoscopic colectomy. Methods: Patients scheduled for segmental laparoscopic colectomy were randomized to receive TEA or PCA. Patients in the TEA group received bupivacaine and fentanyl before incision and after surgery by continuous infusion for 18 h. Patients in the PCA group self-administered morphine using an intravenous pump. The postoperative care plan was otherwise identical for the two groups. Postoperative pain was measured during ambulation using a visual analogue pain score. Results: The study included 38 patients (18 TEA, 20 PCA), 16 of whom underwent right hemicolectomy or ileocolectomy and 22 sigmoid colectomy. Operating times, patient weight and distribution of American Society of Anesthesiologists grade were similar in the two groups. The mean(s.e.m.) total dose of drugs administered was 64(41) mg morphine in the PCA group, and 79(42) mg bupivacaine and 205(140) μg fentanyl in the TEA group. Postoperative pain scores were significantly better in the TEA group at 6 h (mean(s.e.m.) 2.2(0.4) versus 6.6(0.5) with PCA; P = 0.001) and 18 h (2.2(0.3) versus 4.0(0.4); P = 0.003). Hospital stay was similar in the two groups. Conclusion: TEA significantly improved early analgesia following laparoscopic colectomy but did not affect the length of hospital stay.

UR - http://www.scopus.com/inward/record.url?scp=0142247157&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0142247157&partnerID=8YFLogxK

U2 - 10.1002/bjs.4223

DO - 10.1002/bjs.4223

M3 - Article

VL - 90

SP - 1195

EP - 1199

JO - British Journal of Surgery

JF - British Journal of Surgery

SN - 0007-1323

IS - 10

ER -