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Published on: February 14, 2025
Short-term outcomes with intrathecal versus epidural analgesia in laparoscopic colorectal surgery
I Virlos1, D Clements, J Beynon
1Department of Colorectal Surgery, Singleton Hospital, Abertawe Bro Morgannwg University Hospital Trust, Swansea, UK.
Background:
Epidural analgesia is the mainstay of perioperative pain management in enhanced recovery programmes. This study compared short-term outcomes following epidural or intrathecal analgesia in patients undergoing elective laparoscopic colorectal surgery.
Methods:
A single-centre observational study was carried out in 175 consecutive patients who had elective laparoscopic colorectal surgery for benign or malignant disease within an enhanced recovery programme. Seventy-six patients received epidural analgesia and 99 had a single injection of intrathecal analgesia to provide perioperative pain control.
Results:
Patients who had intrathecal analgesia had a reduced median postoperative pain score compared with those receiving epidural analgesia (0 versus 3.5; P < 0.001), an earlier return to mobility (1 versus 4 days; P < 0.001) and a shorter hospital stay (4 versus 5 days; P < 0.001). Return to normal gut function and postoperative nausea and vomiting were similar in the two groups.
Conclusion:
Intrathecal analgesia may have advantages over epidural analgesia in patients undergoing laparoscopic colorectal surgery.
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