Audit of Pain Management After Colorectal Surgeries in a Tertiary Care Cancer Hospital

Surgery for gastrointestinal malignancy is associated with severe post-operative pain, which if inadequately treated, can lead to pulmonary complications and, in addition, delayed mobilization leading to delayed recovery and discharge. We audited our practices looking at the various pain modalities used and their effects on the post-operative recovery in colorectal surgeries, in a tertiary care cancer centre during the era of ERAS. The primary aim of the study was to assess the average pain score on movement in the first 72 h of post-operative period among patients. The secondary aim was to study the various modalities of pain management used and complications, perioperative vasopressor requirement, post-operative resumption of enteral feeding, ambulation, duration of hospital stay, duration of ICU/HDU stay, and worst pain scores in the first 72 h. We analyzed a total of 174 patients who underwent colorectal surgeries for the period of 1 year from 1^st January 2018 till 31^st December 2018. Out of the 174 patients, 86 (49.4%) patients received epidural analgesia and 88 (50.6%) patients who did not receive epidural analgesia, belong to the non-epidural group. Average pain scores on movement at 72 h in the epidural group was 2 [2, 3] and 2 [1, 2] in the non-epidural group (p < 0.001). Worst pain score at post-operative 72 h in epidural group was 3 [3, 4] and 3 [2, 4] in the non-epidural group (p = 0.016). In conclusion, we conclude, that the analgesic efficacy of epidural analgesia was not found to be superior in our study in patients undergoing major colorectal surgeries.